Preamble

The House met at half-past Two o'clock

PRAYERS

[Mr. SPEAKER in the Chair]

PRIVATE BUSINESS

ALL SAINTS CHELSEA BILL

Read the Third time and passed.

BUCKS WATER BOARD BILL (By Order)

Consideration, as amended, deferred till Tuesday next at Seven o'clock.

SOUTH DERBYSHIRE WATER BILL (By Order)

SOUTH DERBYSHIRE WATER BOARD BILL (By Order)

Second Reading deferred till Thursday next.

TORQUAY CORPORATION (WATER) BILL (By Order)

Second Reading deferred till Tuesday next at Seven o'clock.

Oral Answers to Questions — EDUCATION

Teachers

Mr. Fitch: asked the Minister of Education by what authority he fixes quotas of teachers to be employed by local education authorities, since there would not appear to be any legal basis for this action.

The Minister of Education (Mr. Geoffrey Lloyd): Regulation 18 of the Schools Grant Regulations, 1951, of which I am sending the hon. Member a copy.

Mr. Fitch: Will the right hon. Gentleman agree that the quota system is unfair, since it fails to take local circumstances into consideration? For example, in Wigan, my constituency, two-thirds of the schools are denominational, and it is

not always easy to transfer teachers from a denominational school to a State school.

Mr. Lloyd: That is a broader question than that originally asked, but on the whole authorities have co-operated in this measure, and have recognised the need for it. However, I should be pleased to discuss with the hon. Member any particular difficulties in his constituency.

Mr. W. Yates: asked the Minister of Education if he will consider recommending the appointment of a Royal Commission to examine the status of the teaching profession, with terms of reference covering recruitment, training, conditions, salaries and pension rights.

Mr. Geoffrey Lloyd: I am advised on these matters by the National Advisory Council on the Training and Supply of Teachers and by the Burnham Committee. I have full confidence in these bodies and therefore see no need for the appointment of a Royal Commission.

Mr. Yates: Is my right hon. Friend aware that the last Royal Commission sat in 1870? Is he further aware that, although the capital programme is extremely good, many parents and professional people are anxious about the future? Would not the findings of a Royal Commission benefit the nation, the profession, and everybody concerned? Will my right hon. Friend consult his Cabinet colleagues again and see if he can obtain agreement to the setting up of such a Royal Commission?

Mr. Lloyd: I will send my hon. Friend details of the membership of these two bodies, and particularly the National Advisory Council on the Training and Supply of Teachers. He will see that I have available a very wide selection of eminent educational opinion.

Mr. M. Stewart: If the right hon. Gentleman has full confidence in the National Advisory Council, will he take its advice about the extent to which training colleges should be expanded?

Mr. Lloyd: As the hon. Member knows, I took its advice on the main point, which was the objective to be attained.

School Meals

Mr. Fitch: asked the Minister of Education when he proposes to revise Circular 97 regarding the duties of school


teachers in connection with school meals, in view of the fact that the circular was issued in 1946 and conditions have changed since that date.

Mr. Geoffrey Lloyd: I shall issue a new circular shortly.

Mr. Fitch: Will the Minister agree that much valuable teaching time is wasted when teachers have to collect money for school meals and other purposes? Will he consider a more generous unit allowance for school meals, so that local authorities may appoint clerical assistants to do what is essentially a clerical job?

Mr. Lloyd: I think that the teachers appreciate that school meals play a part in the general educational process of the schools, but I recognise that during the recent period of heavy pressure it has been difficult for them. We are discussing this matter with the representatives of the authorities and the teachers.

School Building Programme

Mr. Warbey: asked the Minister of Education to what extent, in his discussions with local education authorities concerning their school building programmes for the year 1960–61, he will have regard to Treasury limitations on the volume of public capital investment.

Mr. Geoffrey Lloyd: As announced in the White Paper, the programme will amount to £55 million.

Mr. Warbey: As many local authorities had to postpone essential school building last year, because of cuts in public investment imposed by the Government, and as the same thing is happening this year as well, what assurance can the Minister give that the not very adequate programme for 1960–61 will not again he axed by the Treasury?

Mr. Lloyd: We are in process of fixing the first two years of this five-year period. I have received the proposals and in due course I will announce definite decisions.

New Schools (Cost per Place)

Mr. Fitch: asked the Minister of Education, in view of the evidence that local education authorities cannot erect schools within the present limits without considerable sacrifice of educational facilities, particularly in the case of new grammar schools, what are his plans in the near future for raising the existing

cost per place for secondary school building.

Mr. Geoffrey Lloyd: The evidence I have shows that local education authorities are still able to build schools of good quality within the current limits of cost per place.

Mr. Fitch: Will the Minister agree that the sum of £264 per place is inadequate for the building of a modern grammar school with the need for technical development? Will he be more generous in his allowances in future?

Mr. Lloyd: The average costs per place on tender have been falling during the last year, so that the situation has somewhat eased, but, again, I am prepared to discuss a particular difficulty in the hon. Member's constituency.

Size of Classes

Mr. Swingler: asked the Minister of Education what percentages of children in the primary and secondary schools, respectively, are being taught in oversized classes at the latest date for which figures are available.

Mr. Geoffrey Lloyd: The figures for January, 1958, were 29·7 per cent. for juniors and 62·1 per cent. for seniors.

Mr. Swingler: Do not these figures show that comparatively little progress has been made in reducing the proportion of oversized classes in schools over the last six or seven years? Is not the secondary school figure particularly shocking in that nearly two-thirds of the classes are overcrowded? How does that figure compare with those of the last two or three years?

Mr. Lloyd: The figure is improving for juniors, although we should like to see it improve even more. There has not been an actual improvement with seniors during the last year. The figure is just about the same as that of a year ago, but it must be remembered that there are more than 100,000 more children in senior schools, so that we have held the position in a rather difficult period.

Minister of Education (Visit to United States of America)

Mr. Chetwynd: asked the Minister of Education whether he will make a statement on his recent official visit to the United States of America.

Mr. Geoffrey Lloyd: Yes, Sir. I was greatly impressed by the friendly interest shown by Americans in our educational system: in particular the academic standards of our grammar schools are much admired. But the main purpose of my tour was to see for myself how the Americans have developed their education system to provide the wide measure of educational opportunity which is the most important objective of the Government's White Paper "Secondary Education for All". My main impression was that the American and British education systems are growing closer together: each in our own way, we have both set ourselves the task of combining equal educational opportunity with high academic standards, particularly for specially gifted children.

Mr. Chetwynd: Is it proposed that there shall be a return visit by an equivalent Minister from America, and that he will see our schools? If so, will he have an opportunity to see our comprehensive schools? Can the Minister say what he will do about this experiment of closed circuit television, of which he made so much on his return?

Mr. Lloyd: We have many American visitors. Although there is no exact American equivalent of the British Minister of Education, because America has a federal system, and education is a State subject, we always welcome American visitors, and they would be free to see all our schools, and we should be proud to show them. I propose to discuss the question of closed circuit television with the B.B.C., Associated-Rediffusion and educational experts. Although there is not time to go into the question fully now, I can say that this would be an interesting way of integrating television very closely with the curricula of schools, in a way convenient to the teachers.

Partially-Deaf Children

Mr. Beswick: asked the Minister of Education what facilities exist in England and Wales generally, and in Middlesex particularly, for the education of partially-deaf children to General Certificate of Education level; how many places are available; and what is the estimated demand for such places.

Mr. Geoffrey Lloyd: Partially-deaf children whose handicap is not too severe

are best educated in ordinary schools, where they have the same facilities as other children to take G.C.E. courses. Grammar school courses for more severely handicapped children are available at the Mary Hare Grammar School for the Deaf at Newbury.

Mr. Beswick: Does the Minister agree that he has side-stepped my Question? I was obviously talking about the partially-deaf children who are unable to assimilate the education given in ordinary schools. Does he agree that a wholly inadequate number of places is available for these partially-deaf children in the school to which he refers, and will he at least see that facilities are provided at the special schools for children to continue their education beyond the age of 15?

Mr. Lloyd: There may be a misunderstanding here. I did not desire to sidestep the question, because this is a very important subject. But partially-deaf children include those who can hear as well as ordinary children so long as they have a hearing aid. I think it will be agreed that those children are probably better in the normal schools. I am considering a proposal to add thirty places to the Mary Hare School, although I have not had evidence that there is a great demand for additional education.

Sir G. Nicholson: Is my right hon. Friend aware that his announcement of an expansion of the Mary Hare School will cause great pleasure to all who know the wonderful work that it does? Can he assure the House that constant vigilance is maintained to see that those partially-deaf children who are not particularly intelligent are not classified as mentally deficient because of their handicap, and are not condemned to bear that stigma, with the loss of the educational facilities available, for the rest of their lives?

Mr. Lloyd: I will look into that point.

Mr. Beswick: Before the general raising of the school-leaving age partially-deaf children were trained for a further two years. Since 1945, with the advance of general education, these children have been left behind, and there has been no increase in their school-leaving age.

Mr. Lloyd: I will certainly look into that matter, and if the hon. Member would like to discuss it with me I should be glad to see him.

Mr. Beswick: asked the Minister of Education what steps are taken at the special schools for partially-deaf children to ensure that such children leave school trained for useful employment.

Mr. Geoffrey Lloyd: The best preparation for useful employment for partially-deaf children is a good general education, which will enable them to take their place in the community on an equal footing with other people.

Mr. Beswick: Does the Minister also agree that some children are unable to take up an ordinary post, such as is open to ordinarily gifted children? Since we spend so much money later on in training disabled people, would not it be a good thing to see if we can fit these handicapped children for a post at school-leaving age?

Mr. Lloyd: I am not sure whether the hon. Member knows of the courses that are available for the partially-deaf children after they have left school, which are given at the Vocational Training Department of the Stretford Royal Residential Schools, which does very good work.

Oral Answers to Questions — TRADE AND COMMERCE

Consumer Interest

Miss Burton: asked the President of the Board of Trade if he is now in a position to make a statement on the proposal made by the Consumer Advisory Council of the British Standards Institution that an independent national body representing every aspect of consumer interest should be established.

The President of the Board of Trade (Sir David Eccles): I regret that I am not yet ready to make a statement.

Miss Burton: I appreciate the right hon. Gentleman's courtesy in this matter, but if he is considering the appointment of a committee to look into this suggestion, will he feel able to draw the terms of reference in such a way that consideration can be given to the usefulness of broadcasting any such reports by a consumer body, both on television and sound radio?

Sir D. Eccles: That is an interesting idea, which I shall certainly consider.

Contract Specifications and Documents

Mr. Goodhart: asked the President of the Board of Trade (1) why a consignment of contract specifications and contract tender documents sent from the United States of America to a prominent firm of British engineers was held at London Airport from 3rd to 14th February until an import licence was obtained;
(2) under what circumstances, under his administrative arrangements, an import licence is needed before contract specifications and contract tender documents may be brought to this country from the United States of America.

Sir D. Eccles: Import licences are not required. Owing to a misunderstanding the importer on this occasion was advised that he would have to apply for an import licence, and I regret the delay which was caused. I have taken steps to prevent any recurrence.

Mr. Goodhart: Can my right hon. Friend assure the House that no import licences are required for this sort of document, if imported from any part of the world?

Sir D. Eccles: Yes, I can. Business documents, contract documents, catalogues, lists and so on, do not require import licences.

Radiogramophones (Price)

Mrs. Mann: asked the President of the Board of Trade if he is aware that retailers of radiogramophones are being offered price reductions by manufacturers on condition that these concessions are not passed on to the customer and are retained to increase the profits; and, as these profit increases range from £4 8s. 8d. to £9 per item, if he will take steps, by the imposition of price control or otherwise, to stop this practice.

Sir D. Eccles: No, Sir.

Mrs. Mann: Is the President of the Board of Trade content to allow these manufacturers to pass on profit reductions of £9 with instructions that they must be retained, and that the list prices must not be reduced? Does not he remember the promise about mending the hole in the purse? Would not a reduction of £9 per set go a considerable way towards repairing the hole in the purse?

Sir D. Eccles: Neither the Board of Trade nor the Ministry of Supply has any power to control the price of radio-gramophones. As I understand it, this case may be one of resale price maintenance by a single firm, in which event it is not illegal.

Pre-packed Food, Vegetables and Fruit

Mrs. Mann: asked the President of the Board of Trade whether he will make a statement on the proposed amendments to the Food and Drugs Act stipulating net weights on packet foods, vegetables and fruits, which were sent to interested organisations by him 14 months ago.

The Parliamentary Secretary to the Board of Trade (Mr. John Rodgers): As I explained in answer to my hon. Friend the Member for Test (Mr. J. Howard) on 19th February, my right hon. Friend has arranged for a social survey to ascertain the habits and needs of consumers in this field. In the light of this survey he will decide whether to proceed direct to a Bill covering the whole weights and measures field or to make regulations under the Board's present limited powers.

Mrs. Mann: Is the hon. Member aware that this is the biggest sell-out of women's organisations that the Government have indulged in? It is fourteen months since every women's organisation was promised these new regulations stipulating the net weight on the packet. All those with whom I have been in touch approved of this proposal. Are we now to understand that it is a complete breach of promise?

Mr. J. Rodgers: There has been no complete breach of faith—[HON. MEMBERS: "Breach of promise."]—or breach of promise. The evidence given by consumer organisations to the Hodgson Committee and subsequently to the Board of Trade is valuable, and we are grateful for it. As the hon. Member knows, my right hon. Friend is anxious to bring up to date the law on weights and measures and to ensure adequate consumer protection, but because of the effects on cost it is not in the consumers' interest to have legislation which disregards practical difficulties. I am sure that no housewife would thank the hon. Lady if the result of her intervention were an increase in prices.

Mrs. Mann: On a point of order. Owing to the unsatisfactory nature of the reply, I beg to give notice that I shall raise this matter at the earliest opportunity.

Trade with U.S.S.R. (Credit Facilities)

Mr. Blenkinsop: asked the President of the Board of Trade what fresh official credit facilities are to be made available to encourage increased sales of British engineering and other products to the Union of Soviet Socialist Republics.

Sir D. Eccles: In recent months Soviet buying organisations have been asking for medium-term credit, instead of their normal 30–45 days terms. The Export Credits Guarantee Department is ready to insure such contracts.

Mr. Blenkinsop: I welcome the Answer of the right hon. Gentleman. Can he go further and say whether he is prepared also to consider longer-term credits which have been asked for in certain cases where considerable orders are in prospect? Does he realise that this is a matter of considerable interest to firms in the North-East and elsewhere, where there is some shortage of orders at present?

Sir D. Eccles: This is a difficult question but one which is well worth while investigating. We are trying to obtain more information from the Russians on the subject.

Newsreel Films

Mr. Swingler: asked the President of the Board of Trade if he will consider bringing newsreel films within the provisions of the quota and levy system, in view of the danger of a decline in production.

Sir D. Eccles: I know of these difficulties. The remedy which is suggested would involve legislation. I am considering this matter.

U.S.S.R. (United Kingdom Trade Mission)

Mr. Edelman: asked the President of the Board of Trade whether he will make a statement on the forthcoming trade delegation to the Union of Soviet Socialist Republics.

Sir D. Eccles: This morning I had a talk with the Soviet Ambassador. It will take us a little time to sort out all the questions involved in preparing for the Mission.

Mr. Edelman: Will the right hon. Gentleman give an assurance that any forthcoming negotiations on national affairs will not hold up the progress of sending such a delegation to the Soviet Union, particularly as the machine tool industry in this country is suffering greatly at the moment and a delegation of this kind could bring considerable benefit?

Sir D. Eccles: It is not for me to give such an assurance, but I can tell the hon. Gentleman that I am anxious to see an increase in trade.

Mr. Jay: Can the right hon. Gentleman say approximately how soon he thinks that this delegation will be able to start?

Sir D. Eccles: No, Sir, at present I cannot.

New Industry, Scotland

Sir D. Robertson: asked the President of the Board of Trade if he will consider setting up a Development Corporation in Scotland, similar to the corporation in Northern Ireland, to attract new industry to towns where unemployment persists, and to others that are threatened by the decline or closure of older industries.

Sir D. Eccles: The Government consider that adequate machinery already exists for this purpose. The functions of the Northern Ireland Development Council are to a large extent discharged in Scotland by the Scottish Council (Development and Industry).

Sir D. Robertson: Is not it a fact that the existing machinery is not doing the job? Does the President of the Board of Trade feel satisfied to continue with an inefficient machine which is handicapped in every way by lack of powers and money?

Sir D. Eccles: I do not think that it is the machine which is not doing the job. The difficulty is to find suitable firms to go to the north of Scotland, but we will continue our attempts to find them.

Mr. Rankin: is the President of the Board of Trade inferring that the Scottish Council (Development and Industry) possesses the same powers, finance, and so on as the Northern Ireland Development Council?

Sir D. Eccles: No, it does not. But we have always considered the unemployment position in Northern Ireland so chronic as to require continuing special efforts. We are now giving D.A.T.A.C. facilities to Scotland.

Mr. Jay: Whether or not the machinery is adequate, would the right hon. Gentleman agree that the results to date have certainly been quite inadequate?

Sir D. Eccles: I wish that we could do better, but it takes a little time to get firms to avail themselves of these facilities.

Balmore, Glasgow (Site)

Mr. Hannan: asked the President of the Board of Trade whether it is still his intention to develop the land at Balmore, Glasgow, as an industrial estate; how long this ground has been in his Department's possession; and from what bodies he has received inquiries about it.

Sir D. Eccles: There are no immediate development plans for this site, part of which was acquired in 1952 and the remainder in the following year. Although a number of industrialists have seen the site none so far has considered it acceptable. We have suggested to the Glasgow Corporation that it might acquire the land.

Mr. Hannan: In view of the failure of the Government in past years to provide for such eventualities as the problem of growing unemployment which now confronts Glasgow, will the Government now afford every facility to Glasgow to make use of this site for the decanting of industry in the overspill plan?

Sir D. Eccles: We have suggested to the Glasgow Corporation that it should take over this site for the re-location of industry as a result of its planning.

Oxygen and Dissolved Acetylene (Monopolies Commission Report)

Mr. Oram: asked the President of the Board of Trade whether, in the light of the profits made last year by the British Oxygen Company, he will reconsider the


decision not to implement the majority recommendation of the Monopolies Commission that the prices and profits on oxygen and dissolved acetylene should be regulated.

Sir D. Eccles: I have no evidence that the company's profit on sales of oxygen and dissolved acetylene has increased materially.

Mr. Oram: When investigating this industry, did not the Monopolies Commission find that the prices were unreasonable and the profits excessive? As last year the profits of the British Oxygen Company were 23 per cent. up on the previous year, is not it pretty certain that the weakness of the Minister in this matter is allowing the profits of the company to swell at the expense of the country?

Sir D. Eccles: I do not think we can draw that conclusion without looking at the turnover of the company and at the whole range of products which it makes.

Mr. Webster: Is not it a fact that the company concerned is implementing, or has implemented, the recommendations of the Commission and therefore that the regulation of the tonnage of oxygen sold to the steel works may in fact increase the prices of that commodity?

Sir D. Eccles: Yes, Sir. The company gave us certain undertakings and I have every reason to think that it is carrying them out.

Tea (International Agreement)

Mr. Oram: asked the President of the Board of Trade whether he is aware of suggestions by tea producers that there should be a revival of the international tea agreement; and whether, in accordance with the Report of the Commonwealth Trade and Economic Conference, he will arrange for Commonwealth talks on this matter.

Sir D. Eccles: Tea producers in certain countries have been considering this suggestion for some time. If we were asked to arrange Commonwealth talks, we should look at this sympathetically.

Mr. Oram: Will the right hon. Gentleman consider taking the initiative himself rather than waiting for the initiative to come from elsewhere? Is not it important that consumer countries as well

as producer countries should be represented in any talks, and that, if the producers take the initiative, the agreement which may result may well be on the lines of the previous one of producers only? Is not modern thinking on these matters very much on the lines of having equal representation of consumer and producer countries?

Sir D. Eccles: I quite agree with the hon. Gentleman that consumers ought to be represented in such agreements. But, as I understand it, the producers as a whole are not yet agreed on a request for talks and I think that we must wait to see whether they are.

Advance Factory, Wales (Site)

Mr. C. Hughes: asked the President of the Board of Trade where it is proposed to site the projected advance factory for Wales.

Sir D. Eccles: My right hon. Friend the Minister for Welsh Affairs and I are considering urgently where to put the factory.

Mr. Hughes: Would the Minister consider building more than one factory? Now that he has accepted the principle of building advance factories, will he consider building them in places where they are needed? Is he aware that, according to the latest figures, the three worst-hit areas in Wales are Anglesey where the unemployment figure is 12·6 per cent., Caernarvon with a figure of 9·4 per cent. and Carmarthen where the figure is 8·1 per cent.? If there is any difficulty in choosing between these three areas, will the right hon. Gentleman build three advance factories?

Sir D. Eccles: As the hon. Gentleman will know, factories are being built in Wales, for instance at Swansea. We will take the claims of Anglesey into consideration, but I do not think it would be a sound policy to dot the country with advance factories without knowing whether we shall get tenants for them. This is an experiment in which I am interested, and we shall have to see how it goes.

Wool Cloth (U.S.A. Tariff Quota)

Mr. Hirst: asked the President of the Board of Trade what steps he has taken to ensure that the case of the British wool


industry has been fully deployed before the appropriate authorities in the United States of America, seeing that the tariff quota at last year's level reduced our exports of wool cloth to the United States market by £4,250,000 compared with 1956.

Sir D. Eccles: Her Majesty's Government have made strong and repeated representations over the past two years about the unfair and damaging effects of the tariff quota on our exports. We have consistently urged the United States Government to take action to remedy this grievance.

Mr. Hirst: Is my right hon. Friend aware that the British wool industry will be grateful for the strong representations which have been made, and in particular for the speech which he made yesterday to the American Chamber of Commerce? Can he, in addition, assure me that the representations have underlined the fact that the switch of American textile interests from wool to synthetic materials and mixtures thereof has, paradoxically, further reduced the quota for British wool textiles?

Sir D. Eccles: I am sorry to say it has, because it has reduced the American domestic production on which the total of the 25 per cent. quota is based.

Mr. Jay: While I also agree with what the right hon. Gentleman said yesterday, may I ask whether he agrees that it is a pity that, both in the matter of the machine tools last autumn and the payment of legacies made a fortnight ago, the Government have made unilateral concessions to the United States without getting anything in return? Have they not learned hat in this matter, as in others unilateral disarmament does not pay?

Sir D. Eccles: It actually did pay, because the machine tools were wanted by British industry to make it more efficient.

Mr. Jay: Why could not the Government have got something in return for those exports in the way of contracts for the British wool industry?

Sir D. Eccles: That would not have been a possible negotiation.

North-Eastern Trading Estates Limited

Mr. Willey: asked the President of the Board of Trade how many people, men and women, respectively, were

employed in the factories administered by the North-Eastern Trading Estates Limited, on the latest available date.

Sir D. Eccles: At November, 1958, 21,728 men and boys and 28,725 women and girls, in total 50,453, were employed in these factories.

Mr. Willey: Does not the right hon. Gentleman agree that these figures are far from satisfactory. We are disturbed that there has been a fall in employment, although slight, since the last figures were announced. Does he realise that we are facing particular difficulties in the North-East?

Sir D. Eccles: I am glad to say that thirty-one extensions of Board of Trade factories have been authorised in the North-East Development Area, and are being constructed.

Mr. Popplewell: Is the right hon. Gentleman aware that there are many empty factories in the North-East, including one at Jarrow, and that we are considerably perturbed about the fall in employment in those areas? Cannot he do something to get industry back there again?

Sir D. Eccles: We are doing our best. That is one of the reasons why it is not wise to build an unlimited number of advance factories.

Mr. Osborne: Does not the President of the Board of Trade agree that, in view of the fact that we have to sell abroad 30 per cent. of what we make and that nobody can make the foreigner buy British, it is stupid to keep on saying "Build new factories" if we cannot sell what the factories produce?

Sir D. Eccles: My hon. Friend is quite right about the importance of exports.

Mr. Willey: Would the right hon. Gentleman not adopt such a pessimistic point of view and realise that the alternative is to have an expansionist policy?

Mr. Willey: asked the President of the Board of Trade how many people, men and women, respectively, were employed in the factories in Sunderland administered by the North-Eastern Trading Estates Limited on the latest available date.

Sir D. Eccles: At November, 1958, 2,254 men and boys and 2,773 women and girls, in total 5,027, were employed in these factories.

Mr. Willey: Is the right hon. Gentleman aware that we very much appreciate that we have now been designated as a D.A.T.A.C. area? Can he further assist us in taking some local initiative? Perhaps his regional controller could come to Sunderland and see what assistance we can give ourselves in directing new industry there?

Sir D. Eccles: I shall be very glad to arrange for my regional controller to pay a visit to the area.

Government-financed Factories

Mr. Jay: asked the President of the Board of Trade in what part of Development Areas the Government are now willing to build Government-financed factories.

Sir D. Eccles: Dundee, Greenock, North Lanarkshire, West South Wales, North East Lancashire and Merseyside.

Mr. Jay: May we take it that in other parts of the Development Areas the Government are not willing to build Government-financed factories?

Sir D. Eccles: It depends upon the state of unemployment in those areas. We also have the Development Commission which is building factories in other areas.

Mr. Jay: May we be clear? The President of the Board of Trade has given a list of parts of Development Areas in which the Government are willing to build Government-financed factories. Does that mean that they are not willing to build factories in other parts of Development Areas?

Sir D. Eccles: For the time being we think that these are the most needy places. It is a great mistake to try to spread the butter too thinly.

Mr. Hamilton: Can the right hon. Gentleman explain the consistency of this Answer, and the Answers to two previous Questions, with the announcement two days ago made by the Secretary of State for Scotland that he is giving the Glenrothes Development Corporation permission to build five advance factories in

Glenrothes? We are not complaining about that, but is the right hon. Gentleman aware that we are not so parochial as to deny the desirability of building further advance factories in other parts of the country, since the Government have evidently established the principle by granting permission to this development corporation to build five factories in Glenrothes?

Sir D. Eccles: It is a different organisation which is building the factories to which the hon. Gentleman refers. The Development Commission also has powers to build factories in North-West Wales, the crofting counties in Scotland, and in Buckie and Peterhead.

Oral Answers to Questions — NATIONAL FINANCE

Income Tax (Schedule A)

Mr. Page: asked the Chancellor of the Exchequer if he will give an estimate of the annual amount of allowances made under Schedule A in respect of land tax, drainage and fencing and embankment charges, and repair of sea walls.

The Financial Secretary to the Treasury (Mr. J. E. S. Simon): The total is of the order of £½ million.

Mr. Page: How much of that comes from owner-occupiers? Is that a reduction of the £34 million collected from owner-occupiers in the year?

Mr. Simon: I could not say without notice.

Mr. Page: asked the Chancellor of the Exchequer if he will give an estimate of the annual amount of the allowances made under Schedule A in respect of tenths and first fruits, duties and fees on presentations, procurations and synodals, repairs of collegiate churches and chapels, chancels, and university colleges and halls.

Mr. Simon: I regret that no information is available.

Mr. Page: Is my hon. Friend satisfied that the Treasury is not making a profit out of the ignorance of people that such deductions can be claimed as is the case with the ordinary maintenance claims.

Mr. Simon: No, Sir. In view of the fact that it has not been considered justifiable to keep statistics of these matters, I can- not be certain of that.

Mr. Page: asked the Chancellor of the Exchequer if he will give an estimate of the annual amount of allowances made under Schedule A for the last complete fiscal year in respect of the deductible five-sixths of a tithe annuity or a rent- charge in lieu of tithe and the deductible one-eighth of the assessment on lands, inclusive of farmhouse.

Mr. Simon: About £2 million and £21 million respectively.

Mr. Page: Is not the cost of the administration of these complicated provisions out of all proportion to the amount collected? Is there really any point in bothering about Schedule A tax any further?

Mr. Simon: I think I have answered that question by my hon. Friend before. There is a very substantial profit to the general taxpayer in the collection of this tax, and costs of administration are by no means disproportionate.

Sporting Rights (Taxation)

Mr. Willis: asked the Chancellor of the Exchequer, in view of the taxation under Schedule A of owners of houses who are occupiers of such houses, whether he will arrange that owners of sporting rights should be similarly taxed when using such rights themselves.

Mr. Simon: I cannot anticipate my right hon. Friend's Budget statement.

Mr. Willis: Will the Minister bear this suggestion in mind, because we think it is reasonable and is based on equity? Will he bear in mind before the Budget that we are now, at public expense, intending to protect and preserve deer forests?

Mr. Simon: I will certainly convey the hon. Member's suggestion to the attention of my right hon. Friend.

Mr. Hannan: asked the Chancellor of the Exchequer whether he will consider extending entertainments tax to cover rentals payable in respect of sporting rights.

The Economic Secretary to the Treasury (Mr. F. J. Erroll): I am not sure

what the hon. Member has in mind, but I will see that any scheme he cares to put forward is considered.

Mr. Hannan: Is the hon. Gentleman aware that lucrative incomes are taken by the owners of deer forests in Scotland which bring no economic advantage to the country, since these activities are carried on purely for entertainment purposes? Is he further aware that by seeking this potential income he could devote the proceeds to a very worthy object, such as the complete exemption of musical instruments from Purchase Tax?

Mr. Erroll: Rentals for shooting rights on grouse moors would attract Income Tax. That point should be remembered.

Paintings, National Gallery (Photographs)

Mr. F. Noel-Baker: asked the Chancellor of the Exchequer what revenue is earned for the National Gallery by granting permission to commercial advertisers to use photographs of paintings which are the property of the nation; and to what extent he proposes to deduct an equivalent sum from the Exchequer grants to the Gallery.

Mr. Simon: Two hundred and fourteen pounds in 1958 out of total reproduction fees of £1,615. Hitherto receipts from this source have been credited to the publications department of the National Gallery. With effect from 1958–59 I have arranged that they should be credited directly to the Exchequer.

Mr. Noel-Baker: While welcoming any source of revenue to the trustees of the National Gallery, however disreputable, may I ask the hon. Gentleman if he does not think that the advertising which appeared for Messrs. Harvey's sherry in which a very famous picture of Goya was used as part of a rather vulgar advertisement—[HON. MEMBERS: "Oh."]—is undignified and undesirable? Will he ask the Trustees to look at this question again.

Mr. Simon: These are, of course, matters of opinion. The trustees are an exceptionally able, cultivated and dedicated body of men and they are well capable of judging what is in the best interests of art in general, of the National Gallery in particular, and of its pictures, with their judgment not clouded by obsessive rancour against advertising.

Purchase Tax

Mrs. Mann: asked the Chancellor of the Exchequer whether, when granting concessions of Purchase Tax, he will seek assurances that these concessions are passed on to the consumer.

Mr. Erroll: No, Sir. The hon. Lady is, I think, aware of my right hon. Lady is, I think aware of my right hon. Friend's view that this is a matter which must be left to the free play of competition.

Mrs. Mann: Is the Minister aware that his free play of competition has been going on since 1951 and with it an increase in the cost of living all the time? Is he aware that he will be appealed to on behalf of retailers to reduce Purchase Tax while at the same time they are circulating a memorandum, a copy of which I have here, giving a £9 reduction to retailers on condition that the reduction is not passed on to the consumers? Is not it imperative in the circumstances that we should speed up any concessions in Purchase Tax and see that they are passed on to the consumers?

Mr. Erroll: I shall be grateful if the hon. Lady will let me see the paper to which she has referred. I can only say that the free play of competition worked very well last year.

Mr. H. Morrison: May I ask the hon. Gentleman whether it is intended when a Purchase Tax reduction is made that the benefit should be brought to the consumer? If that be so, is not the responsibility on the Government to see that the benefit to the consumer is received and that it is not merely left to what he calls the free play of free competition?

Mr. Erroll: This is a complicated plan to administer since the tax is levied at the wholesale stage. In view of our experience last year, we are able to say with real justification that free play of free competition does result in reductions, last year's having been passed on to the consumer with the minimum of delay.

New Factories (Loans and Grants)

Mr. Hector Hughes: asked the Chancellor of the Exchequer the names of the 288 potential applicants for loans and grants who responded to the letter sent last February to 50,000 managing

directors about trade facilities, and indicate what steps he is taking to make available to them loans and grants to set up factories; and where those factories will be located.

Mr. Erroll: The 288 applications for loans or grants which my hon. Friend the Parliamentary Secretary, Board of Trade, referred to in his reply on 3rd March, are at present being prepared for submission to the Development Areas Treasury Advisory Committee. As all approaches to the Committee are confidential, I regret that I am unable to supply any details of the individual applications received.

Mr. Hughes: Does not the Minister realise that this is a matter of grave public importance and that I want to know how many of these loans and grants related to North-East Scotland, where the percentage of unemployment is 5·4 per cent., which is higher than anywhere else in Britain?

Mr. Erroll: That is another question. I was asked about the names of potential applicants from all over the country. It is important to maintain confidentiality as regards each individual applicant.

Mr. Hector Hughes: asked the Chancellor of the Exchequer how many applications he has received during the last five years from potential applicants for loans and grants to set up factories in Aberdeen and the North-East of Scotland; how many of these applications were acceded to; what were the amounts of the grants and loans, respectively, as a result; how many new factories have been built and how many existing factories have been extended; and how many of those applications were refused and are still pending.

Mr. Erroll: Advances from the Development Fund for factory projects were available in the Buckie-Peterhead district from 1953 onwards, but assistance through the Development Areas Treasury Advisory Committee for that district and for Aberdeen was not introduced until the passage of the Distribution of Industry (Industrial Finance) Act last summer.
As regards the Development Fund, the answers to the various questions are: nine inquiries; five firm applications, all of them authorised; and loans approved to a total of £453,999 for the erection of three factories and two extensions.
As regards the Development Areas Treasury Advisory Committee, six firm and eligible applications for a variety of purposes have been received; one has been approved and one rejected, and four are still receiving consideration. All the applications are made in confidence, and I am unable to give details of individual applications.

Mr. Hughes: Is it a fact that the Ministry in considering this matter gives preference to the congested districts of the Midlands and South-East England where the percentage of unemployment is only 1·7 per cent.? Will the hon. Gentleman give more attention to North-East Scotland where, as I said a moment ago, the percentage is 5·4 per cent.?

Mr. Erroll: The Midlands of England are not designated as D.A.T.A.C. areas and in South-East England only one or two isolated coastal areas qualify for D.A.T.A.C. assistance.

Bank Rate

Mr. Jay: asked the Chancellor of the Exchequer his estimate of the effect of the present high Bank Rate upon industrial development, building activity and employment.

Mr. Erroll: Although it is difficult to isolate the influence of Bank Rate from other forces, my right hon. Friend considers that judicious adjustment of Bank Rate from time to time contributes to the health and stability of our financial system, which is the necessary basis for economic activity and employment generally. In this, as in other fields, "high" and "low" are relative terms, and I would remind the right hon. Member that Bank Rate has been reduced five times in the last twelve months.

Mr. Jay: As all that does not mean very much, will the Minister tell me this? If it is true, as the Government tell us, that the £ is now strong and convertibility has made it even stronger, why do we need a continued high Bank Rate in present conditions?

Mr. Erroll: I do not accept the suggestion that it is necessarily at a high rate just now. I am sorry that the Answer I gave did not convey much to the right hon. Member. I took a great deal of trouble to prepare it for him.

Mr. Jay: Is not the real truth that the introduction of convertibility has made the Government afraid to reduce the Bank Rate, although internal conditions require it?

Mr. Erroll: No, I cannot accept the implications in that supplementary question.

Post-War Credits

Mr. Jay: asked the Chancellor of the Exchequer, in view of increasing unemployment in recent months, if he will reconsider his decision not to lower the age for release of post-war credits by five years for both men and women.

Mr. Simon: My right hon. Friend has noted the right hon. Member's suggestion, but he cannot anticipate his Budget Statement.

Mr. Jay: Will the Financial Secretary also note the great merit of this suggestion in that it would preserve the principle of age for release of these credits and also produce a large release in the present year when the Government have created extreme depression in the country?

Mr. Simon: Without in any way accepting the last part of that supplementary question, I shall at any rate undertake to bring the observations of the right hon. Member to the notice of my right hon. Friend.

Lieut. -Colonel Bromley-Davenport: Are not the present figures of unemployment a mere bagatelle—[HON. MEMBERS: "Oh."]—when we think that during the tenure of the recent Socialist Government unemployment rose to between 2 million and 3 million?

Silk Weaving Factory, Great Yarmouth

Mr. S. Silverman: asked the Secretary to the Treasury in what circumstances the Development Areas Treasury Advisory Committee had advanced £10,000 to assist in building a textile mill in Great Yarmouth; and what consideration was given in connection therewith to the empty mills and skilled craftsmen unemployed in the Nelson and Colne constituency and other parts of the North-East Lancashire Development Area.

Mr. Erroll: The offer by the Treasury last November, on the recommendation of the Development Areas Treasury Advisory Committee, of a loan to facilitate the setting up of a silk weaving factory at Great Yarmouth was made under the Distribution of Industry (Industrial Finance) Act, 1958. Great Yarmouth was the location chosen by the applicant and was one of the places for which assistance could be made available under the Act, whereas at the time the offer was made the other places referred to in the question were not.

Mr. Silverman: Is it the hon. Member's assertion to the House that the application was made before 1951? Is he not aware that North-East Lancashire has been a Development Area for seven or eight years, that there are hundreds of empty factories, some of them the best equipped in the country, and that there are many thousands of the highest skilled textile workers now unemployed all over this area? Is not it crazy planning, or the absence of planning, to spend a lot of public money in putting up a new textile mill when we have large numbers of efficient but empty mills already in the country?

Mr. Erroll: This application was for a loan and D.A.T.A.C. loan facilities were not at that time available in Development Areas except where specifically notified in the D.A.T.A.C. list. As for the setting up of a silk mill, and a small one at that, in Great Yarmouth, there is surely something to be said for diversification of employment in an area which is already suffering from a high degree of unemployment.

Mr. Silverman: Owing to the highly unsatisfactory nature of the reply, I shall raise the matter on the Adjournment at a suitable opportunity.

IONISING RADIATION

Mr. Hastings: asked the Prime Minister if he will give figures to compare the amounts of ionising radiation received from the atmosphere during each of the last ten years by London, and England and Wales, respectively.

The Secretary of State for the Home Department and Lord Privy Seal (Mr. R. A. Butler): I have been asked to reply.
I regret that figures in the form requested are not available. As my right hon. Friend the Prime Minister explained to the hon. Member for Meriden (Mr. Moss) on 5th March, there is a national programme for monitoring fall-out which is designed to provide reliable data for assessing the extent to which the population as a whole is exposed to fall-out. Local measurements of total ionising radiation, which would include natural radiation, would not add materially to the value of these data. No figures of fall-out are available for the period before 1951, but the results of the national monitoring programme are now published each year. They do not give cause for concern.

Mr. Hastings: Has the attention of the right hon. Gentleman been called to a statement at a recent meeting of Euratom that in the six central countries of Europe the amount of radiation from above had definitely increased? Ought not we to know whether the same is happening in our country? Is not it true that there is great diversity of opinion among the experts as to the amount of radiation which can fall with safety?

Mr. Butler: Yes, I think there is a variety of opinion among the experts, but I should draw the attention of the hon. Member to the fact that the relevant Atomic Energy Research Establishment reports, the numbers of which I can give him, have been put in the Library of the House and they make available the latest information from our own experts. I think it would be a good thing to study those in order to get some idea of the validity of the Answer I have given.

Oral Answers to Questions — NYASALAND

Situation

Mr. J. Johnson: asked the Secretary of State for the Colonies if he will make a statement upon the situation in Nyasaland Protectorate, with particular reference to the number of African and European casualties so far suffered; and what members of the Nyasaland Legislative Council have been arrested.

The Secretary of State for the Colonies (Mr. Alan Lennox-Boyd): I would refer the hon. Member to the statement I made to the House on 10th March in reply to a Question from my hon. Friend the


Member for Haltemprice (Mr. Wall) and ether hon. Members.
Since then I am glad to say that the Central and Southern provinces have remained comparatively quiet and increased patrolling is resulting in improvement in the Northern province; but further improvement is being delayed by widespread damage to communications and bad weather. Further casualties reported up to and including 11th March are: one rioter killed and two wounded. My noble Friend the Minister of State is now on his way to Nyasaland where he will spend several days before visiting Salisbury and then returning to the United Kingdom.

Mr. Johnson: In view of the appalling African casualties which the Minister has not divulged today, is it not a shocking situation and does it not get worse and worse under ham-fisted handling, particularly in the Northern Province? Why are Dr. Hastings Banda and such members of the Legislative Council as Mr. Chipembere, who are so suspicious of Southern Rhodesia, being sent to detention in Southern Rhodesia and not to a British protectorate such as Northern Rhodesia next door?

Mr. Lennox-Boyd: The hon. Member was less than fair when he suggested that 11 was deliberately hiding figures. I was asked for a further progress report and this is clearly to follow the report I have already made when I gave the regrettable casualties up to date. What I have done is to give the subsequent casualties, which are one rioter killed and two wounded. The hon. Member has the other part of his supplementary question wrong, too, if I may say so. The only member of the Legislative Council who is in detention is Mr. Chipembere. Dr. Banda is not a member of the Legislative Council. I have already made at least one long statement to the House dealing with the reasons why they were detained in Southern Rhodesia rather than in Nyasaland.

Mr. Johnson: I asked the Minister for
a statement upon the situation in Nyasaland Protectorate with particular reference to the number of African and European casualties so far suffered.
I was not given that information.

Mr. Lennox-Boyd: I am ready, if the hon. Member wishes, to repeat the Answer

which I gave on 10th March, to my hon. Friend the Member for Haltemprice and others, but I thought the House would not expect me to repeat an Answer which I had already given. I am quite prepared to give the hon. Member all the facts, however distressing they are, but I understood that he wanted a progress report after my last Answer.

Mr. Albu: In view of the fact that the African Congress is now to be made an illegal organisation in Southern Rhodesia, how can Dr. Hastings Banda ever get out of detention?

Mr. Lennox-Boyd: As far as I know, he is not a member of the Southern Rhodesia African National Congress.

Mr. Bottomley: Can the Minister explain why some Europeans have expressed the view that security forces are not desired in their district because they feel safer with the Africans?

Mr. Lennox-Boyd: I should certainly have to see chapter and verse for that statement before I accepted it.

Sir L. Ungoed-Thomas: Does the Minister realise that his Answer means that 44 Africans have been killed, that no Federal troops have been killed and that no European has been killed? Is this the massacre for which he said a plot had been made? Does he recognise that all the killings have been of Africans and not by Africans? How soon will he withdraw Federal troops from Nyasaland?

Mr. Lennox-Boyd: As I said in my Answer a day or two ago, if Governments are slow in taking action to nip conspiracies in the bud they are blamed for that. If they act promptly and prevent murder, then I think that credit is due. Needless to say, we all deeply regret the deaths among the rioters, most of whom have been duped by their leaders.

Mr. Gaitskell: While I welcome the announcement that Lord Perth is to visit Nyasaland immediately, may I ask whether the Colonial Secretary can say exactly what he is to do there, since I understand that he is not to have discussions on constitutional development? How long is he likely to remain there?
Have the Government come to any conclusion on the proposal that a Parliamentary Commission should be sent to Nyasaland?

Mr. Lennox-Boyd: In reply to the first part of the supplementary question, I think that it would clearly be inopportune at this stage to have formal constitutional talks, but it would equally clearly be helpful if the noble Lord discussed with the parties concerned when in their view it would be appropriate to start such talks. I should think the length of his stay will be three or four days, but he must have a certain flexibility in that matter. Needless to say, we shall be very anxious to welcome my colleague back here and to hear his first-hand impressions at the earliest practicable date. Answering the third part of the supplementary question, I have nothing to add to the replies which I have already given to the House.

Oral Answers to Questions — NORTHERN RHODESIA AND NYASALAND

Deportation Powers

Mrs. Castle: asked the Secretary of State for the Colonies what recent consultations have taken place between the territorial Governments of Northern Rhodesia and Nyasaland and the Federal Government concerning the exercise of their concurrent powers of deportation.

The Under-Secretary of State for the Colonies (Mr. Julian Amery): I know of no such consultations.

Mrs. Castle: Is not that an astonishing reply? Is not it a fact that the territorial Governments have concurrent powers with the Federal Government over deportation? If no consultations take place when deportations occur of the kind which we have seen recently, does not it mean that the concurrent powers of the territorial Governments are meaningless? Does not it mean that control of immigration into all three territories is in fact under the Federal Government and under a Federal immigration board on which no African sits, nor is there a single representative of the two Protectorate Governments? Is not it time that the territories were given greater powers in order to be able to control this very important matter?

Mr. Amery: I understand that the Federal authorities were proceeding not under the Deportation Act but under the Immigration Act. Immigration is the exclusive responsibility of the Federal Government.

Arrests, Southern Rhodesia

Mrs. Castle: asked the Secretary of State for the Colonies what inquiries he has made about the arrests in Southern Rhodesia of British-protected persons, from Nyasaland and Northern Rhodesia, not being also citizens of the Federation.

Mr. Lennox-Boyd: I have asked the Governors of Northern Rhodesia and Nyasaland for the numbers of British protected persons detained, irrespective of whether they are also Federal citizens and about the arrangements that are being made for their families. I have also asked my right hon. and noble Friend the Secretary of State for Commonwealth Relations to seek certain further information about the detainees.

Mrs. Castle: Is not it a fact that if British-protected persons from Northern Rhodesia and Nyasaland who happen to be temporarily resident in Southern Rhodesia are arrested and detained without consultation with their territorial Governments this is a violation of their British-protected-person status? Ought not the Colonial Secretary to have intervened before now, in view of the fact that these people are under his protection and ought not to be arrested without trial by another Government who have no responsibility for their protection?

Mr. Lennox-Boyd: No, Sir. The hon. Lady has that quite wrong. There is no particular right of a British subject or British-protected person to be immune from the law of the country where he happens to be living. These people have been arrested because they were considered a danger in Southern Rhodesia. I ask the hon. Lady to await the full information which I have undertaken to give the House.

QUESTIONS TO MINISTERS

Mr. G. M. Thomson: On a point of order, Mr. Speaker. Question No. 57 relates to incidents which the Secretary of State on Tuesday promised to investigate and on which he promised to make


a statement at the earliest possible moment. Has the Secretary of State given notice that he will answer the Question?

Mr. Speaker: I have received no such notice.

BUSINESS OF THE HOUSE

Mr. Gaitskell: May I ask the Leader of the House whether he will state the business for next week?

The Secretary of State for the Home Department and Lord Privy Seal (Mr. R. A. Butler): Yes, Sir. The business for next week will be as follows:
MONDAY, 16TH MARCH—A debate will take place on the Anglo-Egyptian Financial Agreement, on a Government Motion.
TUESDAY, 17TH MARCH—Supply [9th Allotted Day]: Report.
Consideration of the Civil Supplementary Estimate on Roads etc., England and Wales, Class IX, Vote 2.
The necessary Questions on the Supply Votes required before the end of the financial year would be put from the Chair at 9.30 p.m. under the provisions of Standing Order No. 16, but in view of the fact that opposed Private Business has been set down for consideration by the Chairman of Ways and Means we propose to ask the house to agree to the Questions being put on the necessary Supply Business at 7 o'clock.
Consideration of the Central Land Board (Dissolution and Transfer of Functions) Order.
WEDNESDAY, 18TH MARCH—Second Reading of the Consolidated Fund Bill, which it is proposed to take formally.
A debate will then take place on an Opposition Motion relating to Unemployment.
Consideration of the Import Duties (Temporary Exemptions) (No. 2) Order; and the National Insurance (Earnings) Regulations.
THURSDAY, 19TH MARCH—It is proposed to take the Committee and remaining stages of the Consolidated Fund Bill formally. Afterwards, a debate will take place on Cyprus, which will arise on a Government Motion.
Committee and remaining stages of the following consolidation Measures: County Courts Bill [Lords], and the Overseas Resources Development Bill [Lords].
FRIDAY, 20TH MARCH—Consideration of private Members' Motions.

Mr. Janner: Has the Lord Privy Seal considered a Motion on the Order Paper in the name of 290 hon. Members of the House, including myself, and which is backed by a considerable number of other hon. Members who, for certain reasons, are unable to put their names to a Motion of this sort, as the right hon. Gentleman is aware? Will the right hon. Gentleman give time for the Motion to be debated in the very near future?

[That this House would welcome an opportunity to consider a Motion that the Retriction of Offensive Weapons Bill he read a Second time.]

Mr. Butler: I do not think that there will be time to consider the Motion before Easter, so I cannot give any further reply.

Mr. Janner: But is not the right hon. Gentleman flouting the wishes of the majority of the Members of the House by not giving time to debate the Motion and trying to stop these murderous instruments from being used? Is he aware that unless my Bill goes through—I was about to say without a foolish intervention by some Member or other when it comes before the House on Friday next—the murders and crimes of violence which have been taking place almost daily as a result of the use of these instruments will continue? Will the right hon. Gentleman reconsider his decision?

Mr. Butler: No, Sir. I do not think that it is usual, when an hon. Member has a Bill before the House, to intervene in this way by providing Parliamentary time. I cannot make any observation on the fortune or good fortune which may attend the hon. Member's Bill. The Motion does not enable me to provide Parliamentary time for a subject which is to be discussed on a Private Member's Bill.

Mr. Janner: Whether it is usual or not, it is very unusual for 290 Members to put their names to a Motion that they desire to be dealt with. Surely that calls for an unusual reaction.

Mr. Butler: The hon. Member was fortunate in having the opportunity to present a Private Member's Bill. It is well known that that Bill has not yet been decided by the House. Therefore, we must, first, let the Bill take its course.

Mr. H. Morrison: In view of the number of incidents which have arisen from the use of these nasty weapons, does not the right hon. Gentleman think that there is a responsibility on the Government, if necessary, to introduce legislation? Is not the argument that it is administratively difficult a little bit thin, considering the grave danger to the community which the use of these weapons involves?

Mr. Butler: I had observed that the name of the right hon. Member for Lewisham, South (Mr. H. Morrison) was among those supporting the Motion. As he is an ex-Home Secretary, with great experience of these matters, I have, naturally, paid all the more attention to the support given to the hon. Member for Leicester, North-West (Mr. Janner). But that does not detract from my answer that the hon. Member's Bill must take its course.

Dame Irene Ward: As my right hon. Friend the Prime Minister will in a very short time go to America and, therefore, it is unlikely that time will be found to debate the Motion standing in my name on the order obtained by Messrs. C. A. Parsons and the growing opposition in America to the order, may I ask my right hon. Friend whether he will convey to the Prime Minister the terms of the Motion so that representations may be made at the highest possible level on the recommendation of the confirmation of the order?

[That, in the opinion of this House, the Prime Minister, during his forthcoming visit to the President of the United States of America, should take an opportunity of mentioning the anxiety of the British people at the opposition developing against the confirmation of the order obtained by Messrs. C. A. Parsons, of Newcastle-on-Tyne, in open tender from the Tennessee Valley Authority, and that the Prime Minister should convey the good will that exists in this country for Americans and express on behalf of the British people the

view that they do not believe that an action destroying a unity which is cemented by sound trade relations could be contemplated by those on whose friendship and co-operation they place so much reliance.]

Mr. Speaker: The hon. Lady's Question does not arise on the business for next week.

Dame Irene Ward: On a point of order. Is it not usual to be allowed to draw attention to the terms of a Motion? [An HON. MEMBER: "No."] Yes, certainly.

Mr. Speaker: We are now dealing with the business for next week. It is permissible for hon. Members to ask whether a certain Motion is coming on. I did not understand the hon. Lady to ask about the business for next week. I understood her to ask the Lord Privy Seal to convey a message to the Prime Minister. That is not relevant to the business for next week.

Dame Irene Ward: I should be delighted to ask whether we can debate the Motion next week, Mr. Speaker. May I therefore ask my right hon. Friend whether he can find time for it?

Mr. Butler: The answer, in short, is, "No, Sir." The answer to the unallowed question is, "Yes, Sir."

Mr. S. Silverman: May I revert to the question asked by my hon. Friend the Member for Leicester, North-West (Mr. Janner) and remind the Leader of the House that there is a precedent for the procedure which my hon. Friend pressed upon him? In the days when there was a Private Member's Bill for the abolition of the death penalty, and it was desired by a large number of hon. Members that time should be provided to discuss it, the same procedure was followed as that which has been followed by my hon. Friend the Member for Leicester, North-West.
A large number of hon. Members on both sides of the House tabled a Motion asking that time should be found for a Second Reading. Although the Government on that occasion did not find time for Second Reading, they found time for the subject to be discussed on a Motion of their own. Could not that procedure be followed on this Motion?

Mr. Butler: No, Sir. I regret that I cannot accept the hon. Member's suggestion. The hon. Member for Leicester, North-West has had the opportunity to present a Private Member's Bill and I think that we should let the Bill take its course.

BUSINESS OF THE HOUSE

Ordered,
That this day Business other than the Business of Supply may be taken before Ten o'clock.—[Mr. R. A. Butler.]

Proceedings of the Committee of Ways and Means exempted at this day's Sitting, from the provisions of Standing Order No. 1 (Sittings of the House).—[Mr. R. A. Butler.]

Orders of the Day — SUPPLY

[8TH ALLOTTED DAY]

Considered in Committee.

[Sir CHARLES MACANDREW in the Chair]

CIVIL ESTIMATES AND ESTIMATES FOR REVENUE DEPARTMENTS, SUPPLEMENTARY ESTIMATES, 1958–59; CIVIL EXCESSES, 1957–58

CLASS IX

VOTE 2. ROADS, ETC., ENGLAND AND WALES

Resolved,
That a Supplementary sum, not exceeding £11,262,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for expenditure, including grants and loans to highway, &amp;c., authorities, and to the British Transport Commission, in respect of roads in England and Wales and services connected therewith, including the construction, improvement and maintenance of roads, road research, road safety, the provision and maintenance of vehicles and equipment for use by police forces engaged on certain duties, salaries of surveyors, and the stopping-up and diversion of highways and advance payments in respect of land acquired for trunk roads; for expenses in connection with the collection of motor vehicle duties, &amp;c., and the registration of motor vehicles in Great Britain; and for certain compensation payments.

CLASS V

Vote 5. National Health Service, England and Wales

Motion made, and Question proposed.
That a Supplementary sum, not exceeding £16,589,706, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the provision of a comprehensive health service for England and Wales and other services connected therewith, including payments to Northern Ireland and the Isle of Man, medical services for pensioners, &amp;c., disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, certain training arrangements including certain grants in aid, the purchase of appliances, equipment, stores, &amp;c., necessary for the services, and certain expenses in connection with civil defence.

3.41 p.m.

The Minister of Health (Mr. Derek Walker-Smith): The amount of this Supplementary Estimate for the National Health Service represents an increase of


just over 3½ per cent. on the original Estimate of £472,459,430 for the year. There are four main items, each of £1 million and upwards, that go to make it up. The first is hospital revenue expenditure, at £8,700,000; the second, general medical services, at £2,200,000; the third, pharmaceutical services, at £2,200,000; and the fourth, poliomyelitis vaccine, at £1 million. For the information of the Committee I will, if I may, deal shortly with each of these four items in turn, but perhaps I may say, first, a few general words.
Many of the items in this large Vote for the National Health Service relate to a type of expenditure, the course of which is, in the nature of things, very difficult to predict, and even the figures now appearing in the Supplementary Estimate do not pretend to give a certainty beyond peradventure. The Supplementary Estimate was prepared in January. It represents the best estimate that could then be made, but because of the difficulties of predicting so much of the expenditure we cannot, even now, be certain that it forecasts within precise or narrow limits the expenditure that will, in due course, be shown to have been incurred.
Having made that preliminary and precautionary observation, perhaps I may now come to the first main item—the £8,700,000 for hospital revenue expenditure. The original Estimate for hospitals was £354,566,000. The revised Estimate is £363,262,000—an increase of £8,696,000, which I have rounded up to £8,700,000. In considering this item, the Committee should have in mind the very large proportion of this expenditure that is devoted to the salaries and wages of medical, nursing and other staff directly employed in the hospitals. Thus, in this connection, in the original Estimate of £354½ million, wages, salaries, and so on, account for no less than £228½ million. As a matter of proportion, this means that well over 60 per cent. of the hospital revenue account is for wages and salaries.
For the information of the Committee, I would like to analyse this hospital item. The £8,700,000 is made up of Whitley awards, £3½ million; price increase, £½ million; acceleration of maintenance work and replacement of equipment, £4,600,000, and plant replacement—among smaller items—£100,000.

That totals £8,700,000. Of that amount, increases in wages and prices together account for £4 million, but that increase of £4 million compares with an increase, in respect of the same items, of twice as much—that is to say, £8 million—in the last financial year, and of £13 million in 1956–57.
The Whitley item comprises, in the main, three large awards, accounting for nearly £3 million of the total. The first was the award of £1,626,000 for the domestic and ancillary staffs; the second was for the administrative and clerical staffs—being the regrading exercise which we successfully achieved—£927,000; and the third was for the medical and dental staff—£325,000. The total for the three is £2,878,000.
The third of the component parts of the hospital amount is the £4,600,000 for acceleration of maintenance work, replacements, and so on. I think that the Committee will agree that this is obviously worthwhile expenditure. I am glad to say that it also reflects the strength and position of sterling. In August last, the £ was so fortified by the efforts of my right hon. Friend the Chancellor of the Exchequer that it was possible to make available additional funds for building maintenance, domestic repairs, and renewals. I do not suppose that any hon. Member quarrels with expenditure on this good and worthwhile work—

Dr. J. Dickson Mahon: Would the right hon. and learned Gentleman be good enough to give us the breakdown of the price increase of £1 million in terms of equipment, and so on?

Mr. Walker-Smith: I am not quite sure that I caught what the hon. Gentleman is asking for. The total of price increases within the £8,700,000 is only £½ million. That is only one-eighteenth of the item for hospital revenue expenditure which, in turn, is only half of the total Supplementary Estimate with which we are dealing. Therefore, the total of the price increase is only about one-thirty-sixth of the Supplementary Estimate overall. I gave the comparative figures to show how wages and prices compare with those in previous years, and if the hon. Gentleman wants a breakdown of the small figure of £½ million my hon. Friend will seek to provide it when he replies.
The second main item is £2,200,000 for general medical services. This sum arises from two main causes. The first cause is the advance payment on account of the balance of the central pool for 1957–58, which otherwise would not have been paid until next year, and the second cause is money paid on account of the further interim increase of 4 per cent. given to general practitioners with effect from 1st January. The first figure, of course, only represents, in effect, an advance payment of sums already due, and the second relates to an increase of which I heard no criticism when I announced it to the House. I am glad to say that I have heard no criticism since, and I am optimistic enough not to expect any criticism today.
The third main item is the pharmaceutical services. The Supplementary Estimate provides for £2,200,000, bringing the total cost to about £69 million for these services. This includes the cost of drugs and the payments made to chemists and dispensing doctors for their professional services and to meet their overheads. The total of £69 million, of course, is a large amount, but I think that it should be kept in perspective. The revised estimated total cost for the National Health Service for England and Wales this year is £675 million, of which the pharmaceutical services represent about one-tenth. That proportion, as the Committee may recall, has remained more or less constant over the last three or four years.
If I may say a word about the place of prescriptions in this matter, the expectation of the original estimate in respect of prescriptions was that there would be about 216 million prescriptions at an average cost of 6s. each. Our present expectation is that there will be fewer prescriptions at a higher cost, that is to say, that there will be 205 million prescriptions at an average cost of 6s. 5½d.
The charge of 1s. per item which was introduced in December, 1956, as the Committee will recall, in lieu of the previous charge of 1s. per form, had the result that some doctors prescribed larger quantities of drugs at less frequent intervals, as I think we have noticed before in the House. The number of prescriptions fell accordingly. But then a corrective influence came on the scene,

operating in the reverse direction, to wit, the Asian 'flu epidemic of the autumn of 1957. That, of course, in the nature of it, had the reverse effect, increasing the number of prescriptions and reducing their average cost, because it is a fairly elementary disease.
This corrective tendency introduced by the Asian 'flu epidemic was taken into account at the time of the original estimate. Of course, the incidence of epidemics, it goes without saying, is a notable cause of fluctuation in the numbers and prices of prescriptions. There has always been a considerable fluctuation in the number of prescriptions. If I may take an example from some years back, when right hon. and hon. Gentlemen opposite were in office, there were, in 1949, 202 million prescriptions, rising in two years to 228 million, an increase of 13 per cent. I quote that example to illustrate that there is always a considerable margin of fluctuation in these things, and there is, therefore, no possibility of having the precision of estimation which one would otherwise wish.
As to the reasons for the increase, there is, first, the general upward trend of costs which has been reflected in drug costs as in other things. Secondly, there has been the introduction of new drugs and preparations. The newer drugs, for example, antibiotics, corticosteroids, and certain cardiac preparations now account for about 40 per cent. of the total ingredient cost of prescriptions. One single new drug introduced early this year, which is of particular value in the treatment of elderly patients, may now be costing £1 million a year.
This illustrates how, when we have a new drug of great therapeutic value, it may have the effect of increasing the outlay on the pharmaceutical services. But the cost of these new drugs must obviously be balanced against their value to the community, not only medically—that is important, of course—but also for the contribution they make indirectly but none the less powerfully to the national economy by shortening illness and thereby promoting a speedier return to work. The pharmaceutical industry has considerable achievements to its credit for which the nation should be grateful.
The third main reason for increased costs in this respect is the prescription of increased quantities, with which I have


been dealing, but I should like to say that this is not necessarily uneconomic. In many cases of chronic illness, it is a perfectly proper practice and not necessarily wasteful at all. As a general tendency, it was particularly marked, as I said, in 1957 following the change in the basis of the prescription charge. But this tendency to prescribe larger quantities does not seem to have gone significantly further since that time and does not appear to have been increasing further this year.
It is clearly right that the Committee should scrutinise these figures keenly. I certainly approach the matter in no mood of complacency. As the Committee will know, we have devised many useful methods of keeping the drug bill within reasonable bounds. There is an agreement about the prices of most preparatory preparations which was negotiated with the industry to operate for a trial period. That trial period is now going on; we are rather more than half way through it. We are watching its progress very closely in the context of what the position will be and what it should be at the end of the trial period.
At the same time, we are doing all we can to encourage economy in prescribing among doctors. I am glad that the Hinchliffe Committee, on the Cost of Prescribing, in its interim Report, found that, on the whole, doctors are careful in prescribing at the public expense and exercise due responsibility. I am adopting the Committee's recommendations made in its inteim Report designed to secure that fuller information is put in the hands of doctors to help them in discharging this duty. I am looking forward also to receiving the Committee's final report, perhaps next month, and I shall at once, on its receipt, devote careful and constructive consideration to its further suggestions.

Mr. A. Blenkinsop: Will the Minister make any comment on that very interesting analysis published in the Lancet as to the effect of the increased charges on drugs?

Mr. Walker-Smith: I did deal with that rather fully at Question Time in the supplementary answers I gave, I think, to the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) or to one of

his hon. Friends. I made the position clear at that time. If the hon. Gentleman wishes to pursue the matter, in the light of that, no doubt he will have an opportunity to catch your eye, Sir Charles, and then my hon. Friend will deal with any further points which the hon. Gentleman cares to make about it. I did say then that we felt that the comment was not entirely appropriate—I do not say misconceived—for the reasons I then gave.
I now come to the last main item. It may be the smallest financially, but it is important. It concerns the £1 million for the purchase of poliomyelitis vaccine. We have made considerable strides, I am glad to say, with our immunisation programme in this year, 1958–59. At the end of 1958, over 6 million children had been vaccinated twice, and nearly a quarter of a million who had had one injection were awaiting their second injection. Over three-quarters of a million received a third injection as a result of the expanded programme which I was able to announce to the House last July. There is at present plenty of vaccine available for late registrants, and, therefore, parents who have failed to register their children should not delay longer if they want to ensure that they are vaccinated before the start of the next season of poliomyelitis.
Unfortunately, young adults, the 15 to 25s, who also figured in the extended programme which I announced in July, instead of showing the traditional impetuosity of youth, have been dragging their feet. I would, therefore, through the Committee, tell them that they should now come forward at once in their own interests. It is true that the incidence of poliomyelitis in this age group is not quite as high as it is with the younger children with whom we were previously dealing, but, on the other hand, for those who contract it at that age the severity of the attack and the degree of paralysis are alike much greater.
I therefore sent letters to local health authorities making suggestions about arrangements that might help to improve the response of this age group. I am glad to say that the authorities, with the co-operation of general practitioners, employers and others, and with the help of publicity measures, are making strenuous efforts to bring this group in. I hope, also, that hon. Members will use


their influence and good offices to advise these young people to act now in their own interests.
I have covered the four main items of the Supplementary Estimate, and I trust that what I have said will show clearly that this Supplementary Estimate is not in any way due to extravagance, but rather reflects valuable results in terms of the progress of the service and the well-being of those who work in it.

4.3 p.m.

Dr. Edith Summerskill: I am sure that the whole Committee would like to thank the Minister for the detailed manner in which he has dealt with this Supplementary Estimate. I intend to address myself to two items, namely, the one dealing with the additional sum needed for hospitals, and the other the pharmaceutical services.
To take the hospitals first, this sum is additional to the revised Estimate, and I think that the House will agree that it is a very large sum of money. It always seems to me that the sum used by the hospital service is disproportionate to some of the other services—for example, the general medical services. I do not propose to pursue that point, except to this extent. I remind the Minister—it has been said time after time in the House—that the expensive hospital service is being used in some measure as an alternative to a less expensive welfare service.
A hospital working at a cost of £25 a bed may well contain many aged patients who could be accommodated comfortably and less expensively elsewhere. Indeed, they could be accommodated even more pleasantly than in a hospital. The House must address itself to that matter. As the Minister said, this very large sum of money which is needed for the hospital service is in a large measure spent on wages and salaries, which are embodied in the very large sum of £25 per bed.
Apart from wages and salaries, the Minister has mentioned the higher prices for new equipment, maintenance, and so on. Not for one moment would I question the cost of the equipment, the necessity to pay the staff adequately or the high cost of maintenance. It may well be argued that the additional sum for which we are asked is a small proportion of the original Estimate, but it is the time-honoured right and duty of this House

to inquire into how these sums are arrived at and by whom, and particularly the criterion which the Minister adopts when he decides that an additional sum is needed for the hospital service.
I have with some effort, owing to the small size of the print, examined some of the costing returns of hospitals which operate the alternative and the main scheme. No doubt, when these schemes have been in operation a little longer, we shall be able to make further comparisons between the costs of comparable hospitals. That is absolutely fundamental. It is of little value to the House for the Minister to say that something costs either less or more than something else. We must always have comparable costs. No doubt we shall be able to promote further economies and improve efficiency. Consequently, the recommendations of the working party on hospitals costings which have been implemented have proved extremely valuable.
While these very detailed summaries of hospital costs will provide important statistics for regional hospital boards, teaching hospitals and the Minister, a real assessment of the efficiency and effort to promote economy can be made only by somebody in authority on the spot who can see for himself precisely what is happening and what is needed. For six years I served on the committee of a hospital where the medical director combined first-class surgical skill with an administrative flair and a social conscience for the taxpayers' money.
I am well aware that that is an unusual combination of qualities and I know that it has been decided to change that arrangement for a greater degree of lay administration. However, those who understand the day-to-day working of a large hospital know that only good medical administration can ensure efficiency combined with economy in the medical sphere. I will go so far as to say that only a doctor can speak to a doctor. Therefore, before granting these additional sums, I should like to know the criterion which the Minister adopts regarding efficient administration.
It is five years since the Bradbeer Committee reported on the internal administration of hospitals. It produced a good Report, but we do not hear very much about it. I should like to hear more


about how this Report being implemented from the Parliamentary Secretary when he winds up the debate. The Committee made various recommendations and I should like to know how they have been put into effect. They are closely related to the efficiency of the service and the related costs which are reflected in a limited measure in the Supplementary Estimate before us.
The Minister will recall that the Bradbeer Committee recommended that a medical administrator should be appointed in the larger hospitals. The cost of many of the things about which the Minister has spoken would come within the purview of the medical administrator. That Committee also recommended that he should be a consultant, combining clinical with administrative duties and working in close association with the matron and lay administration.
The Bradbeer Committee envisaged the medical administrator as giving advice to the governing body on the available use of beds. I remind the Minister that many of my hon. Friends have raised the problem of waiting lists. He will recall that we had a most interesting debate the other night when my hon. Friends representing constituencies on the North-East Coast drew the attention of the Parliamentary Secretary to the long waiting lists of that area. My hon. Friends representing constituencies in Birmingham and Manchester have also drawn the Government's attention to long waiting lists in those areas.
The Bradbeer Committee said that if an administrator of the kind I have described were introduced into those hospitals one of his functions would be to observe the waiting lists and try to keep them down.

Sir Keith Joseph: The right hon. Lady has not referred to a much more recent Report than that of the Bradbeer Committee, the Boucher Report, which draws attention to the fallacy of comparing waiting lists with each other, although some of them in some areas are compiled on out-of-date principles and do not reflect the true current needs of the local population. Surely the right hon. Lady should be asking that waiting lists should be realistic before being compared with one another.

Dr. Summerskill: I assure the hon. Member that waiting lists are realistic. If he had troubled to be present at our most recent debate, only two weeks ago, the debate on the position on the North-East Coast, he would have heard hon. Members being completely realistic in their approach to this matter and the Parliamentary Secretary's reply to the debate.
My point is: is there proper supervision of these important aspects of medical work? It was also recommended that the administrator should undertake liaison work with the regional board, the local health authority and the local executive councils. That approach would also ensure the more efficient conduct of hospitals. It is said that the administrator should be responsible for the supervision of admissions and discharges and, as I have already said, the survey of the waiting lists, which would put him in a position to advise on the employment of whole-time or part-time consultants—and I am very pleased to see my hon. Friend the Member for Birmingham, All Saints (Mr. D. Howell) in his place, and I hope that he will raise this matter again. There is a difference of opinion about whether the part-time consultant approach is wasteful. I am sorry that the Minister did not deal more with those day-to-day problems which have been brought to his notice during the year by hon. Members from different parts of the country.
It has also been recommended that the administrator should survey medical staffing. The Minister has told us again today that a large proportion of the amount spent by hospitals is devoted to medical staffing, but we should have been very pleased to learn just how medical staffing is determined. In our most recent debate, we were told that the number of medical staff per 1,000 of the population on the North-East Coast was very much lower than the corresponding figure for the South. We were not given any reason for that, for which I do not blame the Parliamentary Secretary, because he cannot know all the answers. I specifically asked what the pattern of staffing was and how it was decided that there should be one pattern in one area and a different pattern in another. That sort of difference causes hard feelings and gives rise to Questions in the House.
Another recommendation—I think by the Bradbeer Committee, although it might have been in a more recent report—was on the employment of lay workers, another wry important matter. It was brought out in a recent report on maternity, when the Minister was advised that wherever possible midwives and nurses in hospitals should he helped by lay workers who could do domestic work which would otherwise take the time and effort of professional workers. This is a means whereby great economies could be effected, and I hope that we shall hear more about it. It is an important approach to the staffing of our hospitals.
It was recommended that the medical administrator should supervise the medical equipment and medical supplies in cooperation with the chief pharmacist. In discussing the whole subject of pharmaceutical services, the Minister reminded us of the drugs which have been put on the market, and of their dramatic therapeutic results. Nobody denies that, and there is no doubt that there are hon. Members listening to me who have benefited from those drugs. We all welcome that contribution to medical science in this century.
Nevertheless, at the same time, we must examine the cost of those drugs and discover how those responsible for ordering large amounts of drugs for our hospitals are supervised. Again, it has been recommended that chief pharmacists in hospitals should be carefully supervised. It is not enough to say, as we are often told, that a medical advisory committee is functioning and that it examines demands for and costs of new medical equipment. I have friendly feelings towards those medical committees in hospitals, committees of doctors. However, a member of such a committee is not always prepared to demur at some expenditure which he may think unjustified, because he might find a future request of his own refused.
I attach great importance to the overall authority of one person who can make decisions and recommendations in the interests of economy and efficiency. I want to know, therefore, how far the recommendations of the Committee on Hospital Administration, set up by the

Central Health Service Council, have been carried out.
I want now to refer to the sum additional to the revised Estimate for pharmaceutical services. The Minister has been very frank about this in the Explanatory Note, which says:
A saving, resulting from an expected reduction in the number of prescriptions below that assumed in the original estimate, is more than offset by higher average costs per prescription attributed largely to new drugs and preparations.
I am surprised that it does not say that it is also attributed to over-prescribing, because the Minister has not attempted to hide that fact.
What the Minister said and what is paraphrased in the Supplementary Estimate is precisely what I and my hon. Friends warned the Government would happen when they imposed a charge of 1s. per item on a prescription. I do not like to say "I told you so", but here we are dealing with Estimates of a very high order and it was clear that when the Government decided to change their policy they were making a mistake.
A few years have passed and now the Government say that the country must be prepared to pay for the Government's mistake, because that is the one explanation of the Supplementary Estimate. On that occasion, I went into considerable detail, giving examples to show how proprietary drugs with no proven therapeutic value would increase the drug bill. Many of my hon. Friends who were here at the time said that this would encourage over-prescribing.
The recent article in the Lancet has been mentioned. Nobody inspired this article. The people who wrote this article are quite unknown to me, and do not belong, as far as I know, to any political party. After they had analysed the Government's policy, the authors of the article in the Lancet of 3rd January this year—J. P. Martin, who is Lecturer in Social Science at the London School of Economics, and Sheila Williams—on the effects of imposing prescription charges, reached this conclusion:
The charge on each item prescribed led to a sharp fall in the number of prescriptions issued, coupled with a drastic increase in the cost of prescriptions. It appears that about 40 per cent. of this increase was due to doctors prescribing in larger quantities. The strength of this reaction was such as to increase the


net total of the prescription bill by just over£1¼ million, instead of reducing it by £4½ million.
We were told in a most dogmatic fashion that the 1s. tax on the sick, because that is what it comes to, was to raise £5 million, and that very action has resulted in the drug bill soaring. This is borne out by what the Minister said, by what is said in the Explanatory Note and by what is said by people who have examined the situation but who have nothing to do with the House.
In 1956, when the 1s. charge was imposed, the cost of a prescription was 4s. 6d. This afternoon, the Minister told us that the cost is 6s. 6½d.

Mr. Walker-Smith: No, it is 6s. 5½d.

Dr. Summerskill: All right, 6s. 5½d.; I will give the Minister a penny.
The Minister of Health at that time, the right hon. Member for Thirsk and Malton (Mr. Turton) said:
I have to see that there is no extravagance … I can assure the House that we are actively considering ways in which we can reduce the cost … I believe that we must do more. I am sure that we must educate the young doctor so that he knows more about economical prescribing. I believe we have also to go into the question … of the pressure of the salesmanship of the drug houses and the other pressures to which a doctor is subjected. I shall give early consideration to further ways of dealing with that part of the problem."—[OFFICIAL REPORT, 29th November, 1956; Vol 561, c. 710 and 712.]
Here, today, after these promises and after this recognition of the problem, the Minister has to come here and tell us that the cost of prescriptions has gone up by 2s.
The Minister may say, "Well, here was the Opposition dealing with this in a perhaps aggressive spirit." May I tell him what the British Medical Association said—and the B.M.A. is not composed of Socialists, I can assure him. The B.M.A. said:
The composite packs of medical supplies which the Minister said he would introduce and save a shilling or two was not the answer. The B.M.A. warned them that it would create wastage. A further result would be a tendency to over-prescribe which might result in waste and more expense to the Service than ever before.
I must say that I have never before said in this House that the British Medical Association was absolutely vindicated.
What did the Lancet say? On the charge of 1s. per item, it said this:

This decision … will be welcomed by neither patient nor doctor … Given that some further reduction in national spending is required, it is by no means clear why this should be paid by the sick consumer rather than the healthy consumer … More of this new levy will be paid by the average woman than the average man … The average aged person will pay half as much again as the younger person … will bear more heavily on the family man than the individual wage earner.
It is quite clear that the Government were given warning, yet now we are invited to pay a colossal price for drugs. The Government were warned that the charge would be against the interests of the patient and would not reduce the drug bill. In fact, again and again, we have said that it would encourage over-prescribing, and the prescribing of proprietary drugs. In view of this, I ask the Minister, since this act of the Government has increased the price of the prescription and has put up the drug bill, will the Government now abolish the prescription charge in order to reduce over-prescribing?
I can assure the Minister that this is not a political point, because at that time the present Minister's predecessor advised the doctors to over-prescribe. I remember the details so well, when we told the Minister, "If you charge an old person 1s. for, let us say, an 8 oz. bottle of cough mixture in the London smog, the old person living on an old-age pension will say that 1s. is a large amount, and the doctor will say that he will give him a 16 oz. bottle, which will last him two or three times as long." The Minister at that time then said that we should encourage doctors to over-prescribe, and, indeed, that he would allow them to over-prescribe in those circumstances.
If any hon. Members think that that is an exaggeration about over-prescribing, I would ask them to look at their own medicine cupboards in the bathroom, and see the bottles of tablets, the boxes of powder, the ointments, expensive ones, all of them. If the Minister will do me the honour of looking up what I said, he will find that I said that all that the Minister was doing was cluttering up the medicine cupboards of the country. Here is the cost of it—the cost of the clutter. I am not asking everybody to swallow these pills. I would much prefer them to clutter up the cupboards rather than that people should be taking antibiotics


which are not doing them any good. The point is that the country has to pay for that clutter. I therefore hope that the Parliamentary Secretary will tell the Committee whether, in view of this over-prescribing, the Government will now abolish the 1s. charge.
I should also like to ask what other advice from outside this House has been heeded. I remind the Minister of Lord Cohen's advice. Lord Cohen served on the Committee on General Practice within the National Health Service, which said this:
In order to influence students' training in methods of prescribing, the National Formulary and all official published documents on prescribing (including Prescribers' Notes), shall be issued to medical students during their clinical training …
This was also one of the recommendations in the interim Report of the Hinchliffe Committee on the Cost of Prescribing, the Committee which the right hon. and learned Gentleman mentioned. The Hinchliffe Committee also recommended that if doctors are to be encouraged to prescribe official preparations, additional lists should be provided in which proprietary names are arranged alphabetically, together with their official equivalents.
The Minister told us that he was implementing these recommendations. I should like to know specifically from the Parliamentary Secretary which of the 10 recommendations in the interim Report of the Hinchliffe Committee have been implemented. It may be that the medical student to whom I spoke yesterday had perhaps been badly served, but he certainly had not been told, or been given the advice which Lord Cohen said he should be given.
There is one aspect of prescribing which I hope the Committee will examine, and perhaps the Minister himself could help. While the prescription of the general practitioner is examined, may I ask whether the hospital prescription is subjected to the same scrutiny? Is the consultant who likes to prescribe expensive proprietaries, when much cheaper standard preparations are equally efficacious, communicated with? The Minister will know that if a general practitioner is shown to be over-prescribing, he receives a communication and is asked to give an explanation.
I should certainly like to know precisely what treatment is meted to those specialists who are known by general practitioners to favour always the latest proprietary drugs. Is any examination made of the prescribing costs of consultants in the same specialty in different hospitals, particularly in relation to outpatients?
I come now to new drugs and preparations. Every doctor is reminded, as he opens his letters every morning, that the market is still being flooded with new proprietary drugs. The Minister has had questions put to him from both sides of the House about the high charges made by American firms operating in this country. I would remind the House that the most flagrant recent example was raised by my hon. Friend the Member for Islington, East (Mr. E. Fletcher). For two years before July. 1958, the Minister agreed that the prices submitted for corticosteroids were fair and reasonable. He confirmed that in July, 1958. In the four months following July, 1958, there was a drop in price on one item from £56 to £12 per 1,000 tablets. The price reduction was by stages which were all followed simultaneously by the American-owned or American-licensed companies in the United Kingdom.
My hon. Friend the Member for Islington, East was not alone in showing his concern at what appear to be the activities of an American drug ring. The hon. and gallant Member for Knutsford (Lieut.-Colonel Bromley-Davenport), who always amuses the House, is a very vocal supporter of the Government. He has asked Questions of the Minister on this subject. So has the hon. Member for Heston and Isleworth (Mr. R. Harris), another Government supporter. My hon. Friend the Member for Willesden, East (Mr. Orbach), who is associated with six hospitals, has also shown concern.
I think that the Minister will be rather shocked by my next comment. The other day, when this matter was raised in the House, the only support which the Minister received when asked about this matter was from the hon. and gallant Member for Lewes (Colonel Beamish). The hon. and gallant Member was asked to declare his interest. He said nothing. I understand that the hon. and gallant Gentleman, last November, was made a


director of the drug firm, Smith, Kline and French, a private American company. If I have been wrongly informed I shall be only too happy to withdraw this remark, but the source of my information, and the fact that when the hon. and gallant Member was asked whether he had an interest he declined to reply, make me think that the information I have been given is absolutely accurate.

Sir K. Joseph: I am sure that my hon. and gallant Friend the Member for Lewes (Colonel Beamish) has never concealed his interest at all.

Dr. Summerskill: The hon. Member surprises me. Was he in the Chamber on that occasion?

Sir K. Joseph: No, but my hon. and gallant Friend's interest is completely known.

Dr. Summerskill: The hon. Member is very rarely here. He comes perhaps to a major debate on health problems. He interrupted me just now with a question which was entirely irrelevant. If the hon. Member was not here and is completely ignorant of the facts, he must not continually interrupt. I am sure that the Minister would agree that this question of a decrease in price from £56 to £12 per 1,000 tablets needs investigation. On that day when this matter was raised the hon. and gallant Member for Lewes was asked to declare his interest. He leapt up with fervour, but he said nothing. Since then, I have been given the information which I have just passed on to the Committee.

Sir Hugh Linstead: Did the right hon. Lady, as a matter of the ordinary courtesies of the House of Commons, inform my hon. and gallant Friend the Member for Lewes (Colonel Beamish) that she intended to raise this matter today?

Dr. Summerskill: In view of the importance of this matter and the fact that drugs were being discussed, I was quite certain that he would be here.

Sir H. Linstead: Then the right hon. Lady did not follow the usual courtesies of the House?

Dr. Summerskill: When there is a debate and one pursues some matter at length, of course, one notifies an hon.

Member, but does one otherwise inform an hon. Member? I have been a Member of the House for twenty years and I have heard hon. Members time after time mention the names of my hon Friends and continue to pursue a topic without informing them beforehand.
This is one simple question. If I have been misinformed I shall certainly withdraw my remarks. I should not have mentioned it had we not been on the subject of American supplies of drugs at very high prices and this debate had not been on a Supplementary Estimate and I had not believed that hon. Members on both sides take an interest in the matter

Dame Irene Ward: Is not the point that on matters of this kind, when it is a sort of personal allegation, it is common practice to notify the hon. Member concerned that the matter will be raised? On general issues, when one is talking of political philosophy or general behaviour, of course it is not. I also have been a Member of the House for a very long time, and I have always understood that it was common practice if one intended to make a direct allegation, to take steps to inform the hon. Member concerned.

Dr. Summerskill: I have the greatest admiration for the intelligence of the hon. Lady the Member for Tynemouth (Dame Irene Ward), but I am surprised that she should feel it necessary to intervene at this great length on such a minor matter.

Dame Irene Ward: Do not be an ass, Edith!

Dr. Summerskill: If the hon. Lady is fortunate enough to catch your eye, Sir Charles, she should try to make a contribution to the debate of much greater value than her intervention.

Mr. Maurice Edelman: Is it in order, Sir Charles, for the hon. Lady the Member for Tynemouth (Dame Irene Ward) to describe my right hon. Friend the Member for Warrington (Dr. Summerskill) as an ass?

Dame Irene Ward: It is too ridiculous to take that line.

Dr. Summerskill: It shows the paucity of the hon. Lady's argument that she has to descend to vulgar abuse. It shows that she has little left to say.

Dame Irene Ward: Have a sense of humour, woman.

Dr. Summerskill: I am surprised that the hon. Lady should be so feline on this occasion.
To return to the subject. The consumption of certain so-called medicines, particularly in the form of tablets, is an insiduous process. I ask the Minister to take this matter seriously. The country must be vigilant. I would call attention to an artcle in yesterday's Financial Times, a serious newspaper. It was headed: "'Happy Pills' become big business in the United States." It said:
Last year an estimated 225 million dollars"—
equivalent to £80 million—
was spent in America on pills to reduce the tension and anxiety of living.
Apparently, these tranquillisers and energisers—the so-called "happy pills" and "lift pills" respectively—are part of the American way of life. The greater part of this colossal sum was spent on "happy pills", but the "lift pills" are gradually catching up. I do not know whether Abraham Lincoln had "happy pills" and "lift pills" in mind when he talked about the pursuit of happiness.
This question of American firms operating in this country and producing these tranquillisers and advertising them extravagantly in the way we all know they do, must have been brought to the Minister's attention. Every day, every doctor receives leaflets, pamphlets, pills and tablets from American firms. It may be that this pattern of life, which is acceptable in America, may be imposed in this country.
The Financial Times continued:
The happy pill consumption has risen sharply in five years, partly as a result of the promotional activity of the drug companies … This mass consumption of pills that sell for about five dollars to six dollars for fifty, with a daily dosage of three to eight pills, has increased the sales and profits of drug companies substantially.
When we have put Questions to the Minister about excessive prices, inevitably he or his predecessors have assured us that the money is being spent on research, and that research in this country is so limited that we have to depend upon the research in America. If that were so, would his hon. and gallant Friend the Member for Ripon (Sir M. Stoddart-Scott), who is a doctor and

a steady-going supporter of the Government, ask for information about the activities of certain United States companies if he had no good reason?
Yet the hon. and gallant Gentleman alleged the other day that these corn-panics are extracting high prices from the Minister's Department for research, the cost of which is already included in royalties payable to their mother companies in the United States of America. I ask the Minister to investigate this matter. This is imperative, in my view, when a highly responsible Member feels it necessary not to write the Minister a private letter, but to ventilate the matter in a Question.
On other occasions I have given instances of gross overcharge by American firms in this country. It is clear that hon. Members on both sides of the Committee are uneasy about the high prices of proprietary drugs which, the Minister tells us on this Supplementary Estimate, are largely responsible for the rise in the cost of the pharmaceutical services. In fact, £2 million more are being asked for the pharmaceutical services today, chiefly for proprietary drugs, which means that the Minister could not anticipate the rise. The firms in question are now bringing such pressure to bear that a great Government Department such as the Ministry of Health cannot even anticipate an increase of £2 million for proprietary drugs. In view of this fact, I ask the Minister to respond to our request, which has been repeated time after time, for an inquiry into this aspect of the service.
This is the last point I want to raise on the Supplementary Estimate. I am apprehensive that next year we may again be asked for an additional sum for proprietary drugs, and because of that I believe that the whole Committee should now demand an inquiry.

4.44 p.m.

Mr. James Dance: I intervene in this debate only for a few minutes, and I can assure you, Sir, that I shall not be controversial.
A statement has been made by the Mid-Worcestershire Hospital Management Committee which has caused great indignation to many thousands of my constituents. It may be that the same kind of decision has been made by other


hospital management committees, and, if so, it will affect other hon. Members of this Committee and their constituents. I refer to their decision to end all local house committees by the end of the month.
These committees have done excellent work in the past, and so I hope that my right hon. and learned Friend will take some action and allow them to continue. Since the State took over hospitals these committees have been the only close contact between local people and their hospitals. On the principle that a man or woman on the spot knows best what are the local requirements, many public-minded people who have been members of those committees have made many recommendations which have brought great benefits to the smooth running of their local hospitals. Above all, and this is vitally important, they have fostered the human relationship between staff, patients and their friends and relations.
It was not only the decision—though that was of paramount importance—but the way it was announced which caused great indignation in my constituency. The suggestion was kept a close secret, and no reason was given for the decision. There was merely a high-handed announcement that this excellent committee was to be abolished, with less than six months notice. I can bear out what I have said by quoting the Redditch Indicator of 6th March which stated, "Hospital committee closing a bombshell". And it was. It was a complete bombshell to my constituents. I submit that this is not democracy. It is a form of dictatorship.
The town of Redditch in my constituency is particularly affected. Redditch is a very well-run and progressive town on the borders of Worcestershire and Warwickshire. For some time its people have felt that they have been left out in the cold in connection with hospital services. Indeed, some time ago I had an Adjournment debate in the House in which I protested against the closing of their maternity home, and this recent decision of the Mid-Worcestershire Hospital Management Committee is the last straw. The people of Redditch feel strongly that this is their last personal contact with their excellent Smallwood Hospital, and it is to be taken away from them. In

conclusion, therefore, I hope that my right hon. and learned Friend will use his good offices to persuade the management committee to reconsider its decision which, I am convinced, will not only be detrimental to the efficient running of the hosiptal but, as I have already stated, will cause bitter resentment to thousands of people who will not tolerate this form of dictatorship.

4.48 p.m.

Mr. Maurice Edelman: May I turn to some of the wider considerations raised in the course of the Minister's presentation of this Supplementary Estimate? The right hon. and learned Gentleman rejected in anticipation the charge that he might be thought to be complacent, but I could not help feeling that he was smug in dealing with the startling rise in the cost of the pharmaceutical services. I wish briefly to rehearse the development of the cost of those services in the last ten years or so.
The Minister will recall that, in its Report of 1956–57, the Public Accounts Committee drew attention to the continuous increase in the cost of those services, pointing out that between 1949 and 1956 there had been a rise of from £34 million to £63 million in their cost. Today the Minister tells us that the cost has risen still further to the order of £69 million. Also, whereas in 1949 the average cost per prescription was about 3s. 1d., today it has gone up to more than double, to the startling figure of 6s. 5d. per average prescription.
I speak as one who has no connection with the pharmaceutical industry except perhaps as a potential consumer of its products, but I share a widespread anxiety about the startling rise in the cost of those products and its effect on the public, which I would describe as holding up the consumer to ransom. I hope in due course to develop this point and to give one or two illustrations of the way in which this takes place.
I observe in the Report the suggestion that one of the chief reasons for the rise in costs was over-prescription, which my right hon. Friend the Member for Warrington (Dr. Summerskill) has dealt with from the Front Bench, and also the suggestion that doctors have been rather rashly prescribing expensive drugs.
I had the feeling, when reading this Report, that the whole onus of cutting


down the cost of the pharmaceutical service was, in fact, being laid upon the doctors. I want to show this afternoon that, so far from the doctors being at fault, the actual responsibility for the substantially increased cost, particularly in proprietary medicines, lies in the fact that these drugs have fallen into the hands of what I can only describe as a ring of producers which is, in effect, demanding of the consuming public prices which, if they were translated into terms of other products, would cause a tremendous wave of protest all over the country.
Of course, the fact is that the average layman, knowing nothing about the cost, benefiting from the inventions and discoveries of doctors and enjoying the advantages which come from the provision of new and effective drugs, is naturally grateful to enjoy these benefits, while at the same time he must, if he examines the cost of the pharmaceutical service, be appalled at the way in which the pharmaceutical industry is profiting at the expense of the community.
I should like to deal first of all with the question—a matter which I have been interested in for some time—of the cost of anti-poliomyelitis vaccine. The Minister has made a passing reference to the Supplementary Estimate and to the fact that the sum of approximately £1 million is involved. We have not heard from the Minister how much of this money is going for imported vaccine and how much for domestically produced vaccine. We have not heard to what extent, in producing domestic vaccine, he submitted contracts to competitive tender. All we know is that the Minister has come to tie House and asked for another £1 million of vaccine in order to pay for this very desirable object of inoculating a large new class of young people.
Let me say straight away that I believe that only the very best National Health Service is good enough for the people of this country. Let me make it quite clear, in anticipation of what might be said, that in my opinion these remarkable new antibiotics, these corticosteroids which have recently been produced in increasing quantities, are all highly desirable and should be made available to everyone without exception who requires them, and that the test in these matters should

not be the capacity to make contributions but the test of need.
I see that the hon. Member for Leeds, North-East (Sir K. Joseph) has fled from the Chamber before the attack of my right hon. Friend, but I must say that when last year he brought the ladies at the Conservative Conference to their feet in frenzied applause at his suggestion that there should be increased charges for die National Health Service he was doing a great disservice to all those people who have benefited from the National Health Service, because until the present it has been either free or at least almost free.
I want, therefore, to make it quite clear that in my opinion the National Health Service should not only be a free service but the best service available to the people of this country. I want to add that any suggestion that there should be increased charges and increased payments by the patients for pharmaceutical products made available through the Service is merely a suggestion which will benefit the pharmaceutical industry and encourage the very powerful lobby which exists in order to promote the interest of that industry.
The anxiety which I feel about the cost of the anti-poliomyelitis vaccine, the, anxiety which I feel that the market has not been adequately tested, and the anxiety which I feel about the investment that has been made and the manner in which it is being recouped, is nothing compared with the anxiety felt in the United States of America about some of the activities of the companies producing the Salk vaccine, which supplied something like £45 million worth of vaccine to the American health services last year.
I think it is not generally known among the suppliers to this country, suppliers which, no doubt, the Minister has under contract—he will correct me if I am mistaken—that on 12th May last year, and I now quote from the report in The Times, a report which I have confirmed from another source:
Five big American drug firms were indicted today on charges of violating the laws against monopolies in the supply of anti-poliomyelitis vaccine to Federal state and local authorities. The indictment, announced by Mr. Rogers, the Attorney-General, named Eli Lilly and Co., of Indianapolis; Allied Laboratories, Inc., of Kansas City; American Home Products Corporation of New York; Merck and Co., of New Jersey; and Parke, Davis


and Company, of Detroit. The companies were described as the sole producers of poliomyelitis vaccine in the United States from the time the success of the Salk formula was announced in April, 1955.
I quote this in order not merely to suggest that this charge was initiated, as the Minister will know, by the House Committee of Congress, not merely in order to show that Congress is aware of what has been done, but to raise a matter directly relevant to the Supplementary Estimate before the House.
I want to ask the Minister this question directly—and I hope that he will reply to it in direct terms—whether the prices quoted by the five American companies have been uniform prices. If so, it means that we here are enduring the consequences of an activity which in the United States has resulted in a charge of conspiracy.
I must say in fairness that one of the companies charged, Merck and Company, said in a statement that they had charged the market price and that
pricing decisions were made independently, in conformance with the law and the public interest. A statement by Parke Davis said: We have never conspired with other manufacturers to fix or control the price or the market for this or any other pharmaceutical product'.
This is extremely interesting, because it shows a certain amount of simultaneous inspiration, if that is the right term, among all those firms supplying pharmaceutical products, because, according to the report of the house committee which studied this matter, the House Committee, which was headed by Representative L. H. Fountain of North Carolina, a price conspiracy was indicated by the fact that not one but hundreds of identical bids within a fraction of a cent. were received on polio vaccine by Federal and State agencies. I was interested in the activities of some of these companies, and especially in their application to other products which were being bought by the Minister.
Quite recently, I have been interested in a product, which the Minister I believe by inference referred to, called mecamylamine hydro-chloride, marketed in this country under the name of "Inversine" by one of the companies which were named in this indictment as one of the alleged conspirators to keep up the price of anti-poliomyelitic vaccine. The com-

pany which markets "Inversine" is Messrs. Merck, Sharp & Dohme, Limited, a company which, no doubt, is known to the Minister. It is perfectly true—the Parliamentary Secretary has written to me on the subject, and I am obliged to him—that companies which develop pharmaceutical products, particularly if the product is the result of many years of research, are entitled in some way to recoup, either privately or from the Government, their research costs. It is in the national interest that research should be stimulated, whether by means of royalties or by means of an inclusion in the direct price of the product.
On the other hand, having established that, it is utterly wrong that any company should derive from the public a profit of 1,990 per cent. for a corticosteroid drug, a drug designed against hypertension and which is of benefit, possibly, to millions of people throughout the country. It is absolutely wrong that the public should be fleeced in this way—that is the only term I can use—when it is possible for a comparable drug to be produced considerably more cheaply.
When I asked the Minister Questions about it, he replied in two forms. First, on 9th February, when I asked him about corticosteroids generally—that is, drugs against hypertension—he replied:
The original tenders obtained in 1955 showed some price differences, and the subsequent downward movement of prices to uniform levels was, in my view, the result of competition."—[OFFICIAL REPORT. 9th February, 1959; Vol. 599, c. 141.]
In other words, the Minister was arguing that as a result of competition the competitive prices eventually were brought down to a uniform level and that this uniform price was not the result of collusion but was merely the effect of his pressure upon the companies to bring the prices down.
I want, however, to go further than that. I have grave doubts whether this uniform level of prices was the result of competition. In my opinion, it is the result of collusion, that kind of price collusion which can be found throughout the whole of the pharmaceutical industry and about which the public, generally speaking, is little informed.
On 16th February, I went further and asked the Minister a Question which I will not repeat in detail, because it is highly technical, although it has direct


reference to this subject. I asked him whether he would look into the matter in view of the fact that the raw material of mecamylamine hydrochloride, from which the drug "Inversine" is prepared,
is available in Europe at £100 per kilo and that the profit on the price to the National Health Service, after allowances for manufacturing costs, is approximately 990 per cent."—[OFFICIAL REPORT, 16th February. 1959; Vol. 600, c. 4.]
I was wrong in one particular, because the profit being made by the firm was not 990 per cent. but 1,990 per cent. The Minister, very properly and understandably, asked me to bring him proof and to provide the figures on which I reached that conclusion.
Usually, the result of asking the average uninformed inquiry on a subject of this kind is to conclude the matter, but it so happened that I had the figures at my disposal. The Minister will recall that I wrote presenting him with an analysis of how the figure was reached. He said, as is reasonable up to a point, that in the case of drugs it is not merely a matter of considering what are the raw material costs, but that there are many other factors, including research. I accept that, but only in part.
I believe that today there is a twofold process going on. On the one hand, we have scientists like the brilliant team at Beecham's who have recently discovered the variants of penicillin and the possibility of their development on a large scale. We have these distinguished scientists working for science. Then, there is the second stage, and what I regard as the socially immoral stage, when these discoveries are taken up by commercial companies and not used simply, directly and primarily to make them available for the healing of people, but are used instead to reinforce a price ring which is used to exploit the sick. The proof of that exploitation—I willingly use strong language in this matter—lies in the way in which the biggest customer in the whole world, the National Health Service, has steadily had to pay more and more, year after year, for the pharmaceutical products which it buys.
I hope I have said enough to illustrate the point I am making. In this case, I can merely offer an illustration, although I am quite certain that a large number of cases could he produced to reinforce this illustration.
I repeat what I said at the beginning. I believe that the country is being held to ransom by the pharmaceutical industry working in a tight ring, exercising powerful pressure by means of its lobby in order to make sure that this price ring is maintained. Has the Minister investigated these matters with a view to submitting his conclusions to the Restrictive Practices Court, before whom, I believe, they should be brought? The Minister and his predecessors have made a number of well-intentioned gestures. I believe that the setting up of the Joint Committee with the pharmaceutical industry was very good, but we then come to the paragraph in the Report of the Committee of Public Accounts which is cardinal to the demand of my right hon. Friend the Member for Warrington that there should be a committee of inquiry.
The Report from the Committee of Public Accounts, 1956–57, deals with the discussions with the pharmaceutical industry with a view to forming the Joint Committee to investigate the prices of pharmaceutical products and paragraph 19 states:
These long drawn out negotiations have at last resulted in an agreement which is to operate for a trial period of three years from June, 1957. The terms of the agreement and the considerations which led to its acceptance by the Government are described in a memorandum furnished by the Ministry.
Now I come to the point which is fundamental to the strength of my right hon. Friend's case and which underlines the weakness of the Minister's own position. The Report goes on to say that the Ministry's memorandum to the Committee of Public Accounts
explains that the agreed formulae which will govern the prices to be paid have not been built up in a way which allows normal tests to he applied but have been constructed empirically with the object of reflecting the current prices of reputable firms.
Is not the use of the word "reputable" a question-begging adjective? Is it reputable to enter into a conspiracy to keep up the price of poliomyelitis vaccine? In the case of the poliomyelitis vaccine, did the Minister take his prices on the empirical basis of reflection of the current prices of reputable firms? Did he include the firms mentioned in the report from The Times in connection with their indictment before a Grand Jury in the United States of America?
I ask these points because it seems to me that as matters stand today the Minister does not have the means of checking prices. I believe that prices have soared and will continue to soar, and that that is illustrated by the fact that the hoped-for saving of £750,000, mentioned in the same Report, has not materialised All this goes to show that the country has paid substantially more than it should have for its medical services; the Minister has shown himself to be weak in tackling the pharmaceutical industry, and that until we have a strong Minister who is capable of standing up to the powerful interests inside the pharmaceutical industry the prices of pharmaceutical products will continue to soar and the country will continue to be held to ransom.

5.10 p.m.

Mr. Percivall Pott: The right hon. Member for Warrington (Dr. Summerskill) referred to the use of -domestic staff in the maternity homes to ease the staff shortage there. I am sure that the experience of the recent year or two in our big hospitals shows that that is absolutely correct, but I hope that when we consider this matter we shall not forget the many small maternity units in the rural areas, which are playing an equal if not bigger part in the global picture, because the production of domestic staff will not help them. I am thinking of the small maternity unit of which I have a first-class example in my constituency. On more than one occasion I have asked why its records are so much better than the national record, and I am assured by one of the most senior doctors in the area that the only reason is that it was built not as a maternity unit but for a quite different purpose, but that it is the perfect maternity unit.
I have no objection to the Supplementary Estimate, but I am very concerned that we have failed in our endeavours to obtain State-trained, highly qualified nurses, although we have had two committees to tell us how to do it. We are still having to close small units all over the country. We almost had to close the unit in my constituency last autumn, but owing to the terrific drive of the local people we succeeded in obtaining enough trained midwives to keep it going. I understand that we may have to close it in the next few months because of this same difficulty.
If we do close it we shall be putting a load on the domiciliary service which that service cannot carry. In the rural areas, where conditions are more difficult and homes are generally less suited for the birth of children, it is essential to do more than we are doing now to ensure that the small unit is kept available to the people. If it were true that there were not enough trained midwives we should have to face the fact. Various industries have experienced a shortage of qualified people. The horrifying thing is that that is not the position in this case. Less than 20 per cent. of those who qualify as midwives ever practise in midwifery. In other words, we have a large surplus of trained midwives who are not making use of their qualifications but are doing general nursing instead.
I suggest that this proves that we are not making the conditions of service attractive enough to draw into this kind of unit the qualified people we require. We should face this situation and try to attract trained staff into those areas, even if we have to introduce a very high differential. It is not extremely difficult to do this, because we are not considering a specialist staff. A baby born in London is very similar to one born in my constituency. If we make the differential high enough, therefore, we should be able to persuade many qualified people who are now serving in London to help maintain the small units in rural areas, even if they go there only for short periods.
We know that they will carry more responsibility than they would in the great teaching hospitals. They will not have ward sisters, matrons, night matrons and senior matrons above them; they will have to carry the responsibility themselves. But I have no reason to believe that the nursing service has ever been afraid of taking that responsibility, and I would ask my right hon. Friend to realise that he must compensate for the fact that if they go to these small units these people will be living in country districts where they will be strangers, and where the opportunity for promotion will not exist. For that reason we must do something special to ensure that our small maternity units are not closed, thereby throwing a quite unfair load upon the domiciliary service.

5.17 p.m.

Mr. W. Griffiths: As I listened to the interesting speech made by the hon. Member for Devizes (Mr. Pott) I thought how characteristic his attitude was of the schizophrenic attitude of Government supporters generally towards the National Health Service. The hon. Member was quite right to plead with the Minister that in the individual instance to which he referred the Government should find more money. Hon. Members opposite, like hon. Members on this side of the Committee, have always pleaded with successive Ministers of Health that the Government of the day should find more money to help their particular interests. The trouble with hon. Members opposite is that they want more money to be spent on individual items, but at the end of the year they expect the total expenditure to be lower.

Mr. Pott: I did point out that I would not object to my right hon. and learned Friend's asking for a Supplementary Estimate, and I mean that. The hon. Member's case has fallen down on that point.

Mr. Griffiths: No. I noted that the hon. Member said that he did not begrudge the £16 million for which the Minister is asking in this Supplementary Estimate. Nevertheless, it is within the recollection of many hon. Members that for year after year, while hon. Members opposite were pleading on behalf of individual constituency cases in Estimates debates, in general debate and outside the House they perpetually sneered about Health Service expenditure on wigs, the dental service, and the wasteful level of Government expenditure in general. That is why I say that hon. Members opposite have always had a schizophrenic attitude towards the Health Service. But good luck to the hon. Member for Devizes; I hope that he persuades the Parliamentary Secretary to meet his request.
How different this debate is from some that we have had in past years. In the early days of the Health Service, when there was nothing like the amount of statistical information that we have now, incomplete as it may still be, Ministers of Health were assailed by hon. Members opposite for being squander-maniacs, dissipating the national wealth in an improper way year after year. I

am glad that experience of the working of the Health Service over the last ten or twelve years has not only persuaded hon. Members, quite properly, to argue for special constituency interests, but has also persuaded the hon. Member for Devizes to tell the Minister that he does not complain about the £16 million for which the Committee is being asked today. Let us hope that that attitude will be maintained.
Like the hon. Member for Devizes, I wish to refer to a matter which affects my constituency, though, so far as I know, similar problems may face other hon. Members. I refer to the increased difficulty experienced by my constituents and other people in the Manchester area in getting a bed in a maternity hospital. Although we have had the Health Service for eleven years, it is my impression—one which is shared by my colleagues in the Manchester area—that it is more difficult now for a an expectant mother to get a bed in a maternity ward in that area than it was six, seven or eight years ago. At that time a woman who was having her first child was almost invariably able to secure admission to a maternity hospital, but that is not so now.
Every week I receive complaints that expectant mothers who may be living in the most deplorable housing conditions, are obliged to have their first child at home. So far from there being any extra facilities made available in our area, the Prestbury Maternity Centre has been closed, resulting in a substantial reduction in the number of beds available. It is a serious matter. I do not blame the administrators, because they are hard pressed. But, nowadays, an expectant mother is closely cross-examined about her medical history, home circumstances, and so on, and unless the birth is likely to be of great clinical interest, unless there is a possibility of some extraordinary abnormality, an expectant mother has little chance of getting into a hospital.
As one of my constituents remarked wryly to me recently, "If I had been having a two-headed monster, I should have had no difficulty in getting a hospital bed. But because, thank God, I am a healthy woman, and my child will be all right, I do not stand any chance of getting into hospital". The situation is


serious, and I should like the Parliamentary Secretary to say something about it, and if possible, something specifically about the problems in the Manchester area.
I wish to refer to the question of superannuation, and as I shall be speaking of something about which I have an interest I had better declare it. When my Parliamentary duties permit, I engage in my profession as an ophthalmic optician. During the last Session, Parliament accorded statutory recognition to opticians, and one wonders whether this would be the appropriate time to accord to opticians the same advantages of a superannuation scheme as those enjoyed by dentists and doctors. It is true that when this matter was raised originally, the view of the Minister at the time was that it was not possible to accord a superannuation scheme to opticians on two grounds: first, because originally the supplementary ophthalmic service was envisaged as being only a temporary scheme which would be wound up in the unforeseeable future and the ophthalmic service would be carried out through the hospital eye service.
No one who is interested and informed about the service would now argue that the supplementary ophthalmic service will be replaced in the foreseeable future by the hospital eye service. In fact, my right hon. and hon. Friends have declared categorically on recent occasions that they envisage a continuance of the supplementary ophthalmic service. As the situation has changed, perhaps the Government will look at this matter again. There is, consequently, a change in the status of opticians and the part which they can play in the Health Service as a whole. Therefore, without going further into this rather narrow subject today, I hope that the Parliamentary Secretary may be able to refer to it.
I hope that in future, when examining the National Health Service, Parliament will reveal the same spirit of optimism which has characterised the debate today. I hope that after the General Election, when we have a Labour Government in office, the then Minister of Health will implement the policy of the Labour Party which, let me remind the Committee, is to remove all the financial barriers now existing between the patient and the

service he requires. When the Minister of the day is engaged on that duty and asks Parliament for the money necessary, I hope that hon. Members, who by that time will have changed sides in the House, will be as enthusiastic in acceding to this worth-while expenditure as they have been today.

5.27 p.m.

Dr. Donald Johnson: Listening to the right hon. Lady the Member for Warrington (Dr. Summerskill), I am able to follow her as far as agreeing that one of the main anxieties in connection with these Estimates concerns hospitals and the pharmaceutical service and the cost of drugs. We welcome the publication of the costing returns which provide us with something to work on inasmuch as they reveal the strange anomalies to which I drew the attention of my right hon. Friend by means of a Parliamentary Question a short time ago. Apparently, in the case of similar hospitals in Middlesbrough and in London, the figures were £16 per in-patient each week for Middlesbrough and no less than £32 for London, with all kinds of variations in between.
Having ascertained that this is happening, we are able to examine the matter and draw our conclusions. It is not only a question of a sum of £25 for a bed in a hospital when the patient could be elsewhere, but there is also the question of out-patients. To my mind, one of the most disturbing of the figures published is the estimation of the cost per outpatient per hospital which, I think I am right in saying, works out at about 17s. 6d. per out-patient attendance. That is almost as much as a National Health doctor gets for attending that patient throughout the whole year. I realise that it is not entirely comparable; there are all sorts of factors in it. There is no question, however, which is the cheaper and more economical way of getting patients attended.
It is not only a matter of expense but of duplication of effort with the hospital out-patient service. I talk with some experience of the matter as a former general practitioner, and I cannot help feeling that too many trivial, minor cases are sent to the hospital out-patients department. In the first place there may be some excuse for that, but the disturbing thing is that when the patients get


there the hospitals hold on to them and do not send them back to the general practitioner.
I repeatedly know of cases of people who went to hospital for minor injuries or cuts to hands and wrists. They were perhaps properly sent to the casualty department and then the hospitals held on to them for repeated attendances over a week or a fortnight, when they could quite well have been sent back to the National Health doctor.

Mr. R. J. Mellish: This generalisation is a little bit too much for us to stand on this side of the Corn-mince. It is not true within my experience. Out-patients' departments in fact send people back as quickly as possible.

Dr. Johnson: I am pleased to hear that, but it did not happen within my experience. [Interruption.] Excuse my saying that I have been a general practitioner and the hon. Gentleman has not; he must give me the credit of talking from experience in these matters.

Mr. Denis Howell: Is the hon. Gentleman saying that because he is a doctor that is the end of the matter? That is one of the troubles with the National Health Service.

Dr. Johnson: I was talking from my experience of what happened. The hon. Member for Bermondsey (Mr. Mellish) said that it did not happen. Perhaps it did not happen within the hon. Gentleman's sphere of knowledge, but it happened within my sphere of knowledge. I am satisfied that there are cases where it happens, so perhaps the matter could be looked into and tidied up for the benefit of us all.
Duplication of effort and divided administration between the general practitioner, the local authority services and the hospital services are a major drain of expenditure in the National Health Service. That is a matter upon which I could talk at length but do not propose to do in this debate. I hope, nonetheless, that the Minister will look at the matter from the point of view of expense. This overlapping and duplication of effort in the Service is serious. Perhaps my right hon. Friend, when he issues the directive which he has promised us under the new Mental Health Bill, will look

into the question of cross-appointments by hospitals and local authority services. I hope that he will keep this whole matter under review.
I pass to the pharmaceutical service. I shall not do as an hon. Member opposite did and delve into the mysteries of the pharmaceutical industry but deal with the matter from a slightly different angle. It is only proper that we should have new drugs, and perhaps more expensive drugs if they are worth while, as they are in many cases. But we have to ask the question, which I have asked in this Chamber before, whether we are not getting into the habit of thinking that because drugs are expensive they must be effective. That is a very easy habit to get into when prescribing drugs and dealing with them. I have confessed on previous occasions that I am old-fashioned in these matters. I have recommended while speaking here such very worthy drugs as sodium bicarbonate, Epsom Salts and other simple remedies like that, which are still as effective as they were fifty years ago. Their effectiveness seems to have been forgotten. It is forgotten to such an extent that lanolin, for instance, a very worthy thing for cuts and bruises, is sometimes difficult to get.
What disturbs me is that when I go to a chemist's shop and ask for a simple drug like that, or for Dover's Powders, which are very good things to have for a cold, I always find difficulty in getting them because the shop is so filled up with more expensive drugs. We should do something to prevent simple drugs being driven out of the chemists' shops where we ought to be able to obtain them. I hope that my right hon. Friend will, as I have urged before, make every effort to remind prescribing doctors of the worth of these very simple remedies.
I want to come back to the hospital question. At the bottom of the first page of the Supplementary Estimates is one very low figure for capital expenditure on hospital buildings. I am sure that there are valid reasons, of which I do not understand the intricacies, why this figure is so low. But it cannot but remind us of the need for hospital building and of the difficulties we have experienced under the National Health Service in the building of new hospitals.

Mr. Walker-Smith: My hon. Friend appreciates, of course, that this is a Supplementary Estimate only and that our Estimates for the total sums of capital for hospital building are going up in a gratifying and steady acceleration.

Dr. Johnson: I apologise to my right hon. and learned Friend if I seemed to imply in any way that these rather meagre figures represent the total capital. I did not wish to make any such implication at all. I was merely using the figure as an illustration. We welcome the move that is being made towards getting new hospitals built, but nonetheless, looking at the whole range over the past twelve years of the National Health Service, we cannot have any great reason to be satisfied with the number of hospitals being built. I am sure that my right hon. and learned Friend would agree that there are difficulties in providing capital for the number of hospitals that he himself would like to see built. It is not a question of not being willing and anxious to build them, but of providing capital within the limits of our finances.
In that connection, I would repeat what I said the last time I spoke on this subject, at the risk of defying the lightning, so to speak. I consider that the time has come when we might consider whether hospital building efforts might be thrown open to voluntary contributions on a local basis, to supplement what the National Health Service can do. When I mentioned this matter before, I was accused by the hon. Member for Manchester, Exchange (Mr. W. Griffiths) who has just spoken, of producing antideluvian ideas on the subject. He interested me very much. He must have known that I was going to talk about him because he is in the Chamber at the moment. After chalking me off on this matter, he went on to talk about the sparsity of thoracic units in Manchester. Today he has been talking about maternity units. While he was speaking, I thought how nice it would be if the Manchester people could only collect voluntarily to provide capital for their own thoracic units. How nice it would be if we could open this up again on a voluntary basis.
I know that in the past hon. Members opposite have had very good reasons for their antagonism to this voluntary system. They have said that Bournemouth and other wealthy parts of the country had

all the money and could provide fine hospitals whereas the more industrial parts were poorer and would have second-best, but that is no longer true. It is certainly no longer true to the same extent. Wealth is spread more evenly through the country. Manchester is a wealthy place, but there are places like West Cumberland, nearer to my constituency, which in the thirties was one of the poorest places in the country and has been one of the most prosperous since the war. If the question was opened to them they would willingly find capital funds that supply their own needs, whether for general hospitals or special departments.

Mr. Mellish: What is to stop the very virile League of Friends going into a campaign to raise money to erect such a building? That goes on in some areas. Having got the capital, the question is whether the Minister would then make an allowance for the maintenance.

Dr. Johnson: I am open to contradiction, but what I think would stop the League of Friends doing that is the National Health Service Act. I understand it is not legal—I hope I shall be corrected if I am wrong—for funds to be contributed for any purpose directly connected with the therapeutics of a hospital. Funds can be provided for patients' comforts, for telephone trolleys, perhaps for curtains in a ward and amenities of that kind, but I think I am right in saying that they cannot be provided for such things as a thoracic unit, an X-ray department, or anything to do with therapeutics.

Mr. Mellish: I happen to know of a voluntary body which is donating £¼ million as a consequence of which it has given a spur to the Minister to do a little more, and in the South-Eastern Region a new department is going up.

Dr. Johnson: I am pleased to hear that. I hope my right hon. and learned Friend will bring that example to the attention of the rest of the country. As I say, I am entirely open to correction on these matters, and if my impression is wrong I am willing to have it corrected by anything my right hon. and learned Friend or the Parliamentary Secretary might say in reply. I am quite sure there would be great willingness on all sides for voluntary efforts of this kind to be organised on a much wider basis than at present.
I have only one thing further to say. During the course of these debates many of us are a little disturbed by some aspects of the National Health Service. One does not want to be too extreme in any remarks or too critical, nor does one want to derogate from the splendid work done by all who are working in the Service. Nonetheless, anxiety crops up from time to time over the general working of the Service. That was evidenced as recently as 28th February in an editorial in the Lancet, which was consequent on the report on sterlisation practices in hospitals, about which there has been a measure of anxiety. An interesting thing about the article was that it endeavoured to generalise and diagnose the malaise in the Service and spoke of "failure by committee".
The subject of committees in the Service is one we ought to consider. We should consider whether perhaps in the development of the Service we tend to have too many committees rather than too few. Have we not perhaps to some extent "gone to seed" with committees in the administration of the Service? These committees tend to disagree with each other, as The Lancet article said, and at times they tend to quarrel with each other. There are many places in the country where the hospital management committee and the medical committee are at loggerheads. They cannibalise each other and, as my hon. Friend the Member for Bromsgrove (Mr. Dance) said earlier, they commit mayhem and murder on each other. This quarrelling and disagreement among committees is a cause of anxiety throughout the Service. Perhaps my right hon. and learned Friend can look at this committee aspect and, a; a contrast, endeavour to stress the individual responsibility which has always been the historic basis on which British medicine has been founded.

5.48 p.m.

Mrs. Joyce Butler: I want to say a few words about one aspect of the hospital services and to ask two questions of the Minister, both of which relate to the code of practice which was issued by the Ministry of Health in 1957 for the protection of persons exposed to ionising radiations. That code of practice has no legal status, and it is not intended to have any; but it means that since workers in the Health Service have

no legal protection when they are liable to be exposed to radioactivity or X-rays it is important that this code of practice should be implemented.
I believe the Ministry is very anxious that the code should be implemented, because a number of memoranda have been issued over the last two years since it was published and, in December last year, the Minister requested that progress reports on its implementation should be submitted to the Ministry by the end of February this year. The questions I want to ask the Minister arising out of the Estimates in this respect are these: Does his provision for increased remuneration provide any increase for radiographers and hospital physicists? I assume it does not. I listened very carefully to the various awards he mentioned which this item covers. I could not acid them all together and discover whether there was anything left to cover this particular category, but I think there was not. The important thing about the rate of remuneration of these two categories of workers is that the rates of pay are not sufficiently attractive to bring in enough workers of this kind.
This, together with the conditions of service, which are also not as good as they should be, has caused an acute shortage, especially of radiographers. The Minister will have seen in a recent number of the British Journal of Radiology a report by workers of the Royal Cancer Hospital, and the experience quoted in that Journal is by no means unique. It is estimated that whereas the average exposure of Atomic Energy Authority radiation workers is 0·4 roentgen a year, in the case of radium workers it is difficult to hold them down to 0·1 roentgen a week.
This is entirely due to the shortage of these workers. It is an important point and it illustrates the desirability of increasing the remuneration of this grade of worker and improving the conditions of service in order that sufficient can be employed to make sure that the Health Service code for these workers can be implemented. This matter is causing grave concern to many people associated with these workers and to the workers themselves. Is the Minister making any provision for this or considering any way in which something can be done about it?
My second question concerns capital expenditure. If the Minister wants the hospitals to implement the code, does he intend to meet sympathetically any requests which they make for capital grants to enable them to implement the code? If he does not, and if he is expecting them to find the money out of their grants, it may be very difficult for hospitals, which with the best will in the world recognise the importance of implementing the code and are anxious to carry it out, to be able to do so, because it will be a very costly matter. Has the Minister made any provision in the Estimates for capital expenditure of that kind? If not, will he indicate how he expects that kind of capital expenditure for new equipment and all that is associated with it to be met? Does he expect the hospitals to do this out of their grants or will he help them in any way? This is a specialised problem, but it is a matter of great interest and it seems to be one for which the Minister should assume some financial responsibility in his Estimates.
I hope that in his reply the Parliamentary Secretary will be able to make some comments about the two questions which I have asked. If he cannot do so tonight, will he let me know later what is the position?

5.53 p.m.

Sir Hugh Linstead: The first of the two questions which were asked by the hon. Lady the Member for Wood Green (Mrs. Butler), dealing with the supply of radiographers, is particularly important and I shall refer to it later in my speech.
Before I do so, however, I want to refer to the speeches of the right hon. Lady the Member for Warrington (Dr. Summerskill) and the hon. Member for Coventry, North (Mr. Edelman). Once again, we had from them criticisms, in extremely strong and sometimes unrestrained language, about the cost of drugs to my right hon. and learned Friend. I am the secretary of a professional society connected with pharmacists, and I have no connection at all with any firms in the drug industry, but I nevertheless feel that it is a pity that the duty which the House has of keeping a very jealous eye on expenditure on such items as drugs in the National Health Service should be so overladen by the strength of the attacks which are made on my right hon. and

learned Friend as to lose a great deal of their value and force.
Listening to those two speeches one would have imagined that my right hon. Friend was sitting back and allowing himself and the Ministry to be exploited by the industry. In fact, very few industries are more closely under financial scrutiny than is the pharmaceutical industry. The Ministry's accountants are practically sitting in the accounts offices of these manufacturing firms and I doubt whether there is any information about their financial and internal working which is not fully known to my right hon. and learned Friend.
In my opinion, less than justice has been done to the Ministry of Health, the British Medical Association, and the Pharmaceutical Society of Great Britain for the publication of the British National Formulary, which has had a remarkable effect in keeping down the cost of drugs in this country. In Canada and the United States about 90 per cent. of the prescriptions are proprietary medicines, whereas in this country, under the National Health Service, the figure is about 50 per cent. That is very largely due to the publication under my right hon. Friend's auspices of the National Formulary, which is a guide to prescribing.
I am glad that the right hon. Lady the Member for Warrington is still in her place. She made what I felt was an unfortunate attack upon my hon. and gallant Friend the Member for Lewes (Colonel Beamish), without notice, to him and in his absence. If I understood her correctly, she alleged that in a debate in the House he made no disclosure of his interest in the subject—no disclosure of the fact that he was connected with a pharmaceutical manufacturing firm. I have a copy of HANSARD here. I assume that the right hon. Lady was referring to the debate in Committee of Ways and Means on 25th February last year.

Dr. Summerskill: No. I was referring to Questions last week, when the hon. Member for Putney (Sir H. Linstead) was not here.

Sir H. Linstead: In the debate to which I referred my hon. and gallant Friend quite properly made a statement of his connection with the industry, but what was said during Questions is another matter.
At the risk of taking up the time of the Committee I will also refer to some remarks which the right hon. Lady made about the Bradbeer Committee. Here I believe that her memory is somewhat at fault. I had the honour of being a member of that Committee, and I must say that I hardly recognised our recommendations in the form in which the right hon. Lady put them before us today.

Dr. Summerskill: I obtained a copy of the Report of the Bradbeer Committee from the Stationery Office yesterday. I therefore think that my memory is fairly fresh.

Sir H. Linstead: The right hon. Lady must have done a great deal of homework last night. I accept that she did, but she must accept it from me that the Bradbeer Committee never intended to give the impression, and certainly never made any recommendation, that we should embark upon a régime of medical administration of hospitals in the sense in which the right hon. Lady referred to it when she said that it was high time that in hospitals there was one medical person who could take decisions instead of our having to rely upon committees. The essential finding and recommendation of the Bradbeer Committee was what has been called the tripartite system of hospital administration whereby the matron, the chief administrative officer and the senior doctor are all responsible for the general administration.

Dr. Summerskill: The hon. Gentleman is completely misrepresenting me. If he reads my speech in HANSARD he will see that that is what I said. I spoke of the medical administration, the matron and the lay administration, but I said that in my opinion it was necessary for someone in medical matters to have the final word.

Sir H. Linstead: I am grateful for that explanation. I do not think the right hon. Lady will find much support among medical practitioners in hospitals for her suggestion that the medical administrator in medical matters should be in a position to take decisions over the head of the medical advisory committee. It was precisely on that point that the medical members of the Bradbeer Committee were insistent that medical administration of that kind, replacing the

advisory committee by the will of the individual, could not be justified.

Dr. Summerskill: The hon. Member is apparently hingeing his speech on to what I said. What I said about the medical advisory committee was that I did not think that individuals on a committee would be prepared to make a decision, because on a future occasion their department might be questioned.

Sir H. Linstead: I think that I was right in saying that the right hon. Lady said that it was necessary to have a medical administrator to make decisions because committees cannot make decisions. That is simplifying the argument. It was precisely that attitude of mind which was so strongly opposed by the medical members of the Bradbeer Committee.
Two points to which I wish to devote special attention arise on the Supplementary Estimate in relation to the salaries of hospital staffs. First, I want to refer to the position of hospital pharmacists, and then, in particular, to medical auxiliaries employed in hospitals covered by the Cope Report of 1951. These are both specialised subjects, but I believe that both of them require the attention of my right hon. and learned Friend.
My right hon. and learned Friend will agree with me that at the moment the hospital service is short on its establishment of pharmacists by 20 to 25 per cent. That shortage is resulting in extremely rapid promotion of young and rather inexperienced pharmacists. It is resulting in an unbalanced pharmaceutical service with a majority of people at the higher levels and very few coming along behind to replace them. In some hospitals the pharmaceutical staff is becoming dangerously low.
Side by side with that, not enough thought is being given to the employment in the pharmaceutical service of technicians and skilled assistants of one kind and another. The career structure of the service is unsatisfactory, largely because the salary structure is unsatisfactory. At present well over 80 per cent. are on a scale the maximum of which is £1,070 a year. That will be the maximum which they can reach during their professional life. Compared with salaries outside the hospital service, there is no attraction for


competent men to offer themselves for the hospital service.
A solution to the problem has been proposed to my right hon. and learned Friend by the Central Health Services Council. That solution is connected with the conception of the group system in hospital organisation. All of us connected with hospitals are inclined to forget that the new conception of the group was brought into the 1946 Act and ought to be a directive for any development of the hospital service. As and when opportunities occur within a group for consolidating a service, because someone has retired or staff changes have taken place, the existence of the group in the Act should be recognised and an attempt made to build up a group service rather than an individual service.
In pharmacy, that is usually possible. Pharmacy is a service which lends itself to grouping, in relation to purchase of materials, manufacturing and employment of staff. My right hon. and learned Friend will find a solution to the problem with which he is faced by the creation of a group pharmaceutical service. This will meet the basic need for grouping the pharmaceutical service within a hospital group and also help to overcome the weakness of the present career structure. It need not necessarily mean an increase in cost, because I believe that the need is possibly for fewer and better-paid pharmacists, and a better and more organised use of technicians, rather than a substantial increase in the number of pharmacists.
These proposals have been before my right hon. and learned Friend for nearly a year. So far, he has not found it possible to make a public pronouncement about his intentions with regard to group pharmacists and their salary scale. I hope that the pronouncement will not be delayed much longer, because if it drags on the serious drain from the service will continue. I hope that my hon. Friend the Parliamentary Secretary will have something to say about it this afternoon.
My second point is about the number of hospital employees who come within the grade of medical auxiliaries. They are such people as occupational therapists, almoners, dieticians and laboratory technicians. Their future was considered

by a committee under the chairmanship of Sir Zachary Cope, which reported as long ago as 1951. The main regret which I express to my right hon. and learned Friend is that all this time has elapsed and he has not yet found it possible to come forward with proposals for legislation along the lines which the Committee recommended.
The general picture which the Cope Committee proposed was a medical auxiliary council as an overall umbrella to cover all these professions and some other professions, on which there was to be a medical majority. Under the council there were to be professional committees. This recommendation was opposed by most of the professions, particularly because of the medical majority of the council. They were afraid that the individuality of their professions might be overwhelmed by the medical members of the council.
One should have a great deal of sympathy with the desire of well organised professions to retain their entity and not be subordinated to the views of doctors, although my right hon. and learned Friend will have to balance against that consideration the fact that the majority of these professions, if not all of them, work under medical supervision.
The Report was published in 1951. A working party was set up in 1954 and reported in the same year. Not until 1958, after a delay of four years, was anything further heard of the recommendations of the working party. In 1958, a conference was called and a decision is now awaited from my right hon. and learned Friend. These professions are entitled to say to the Minister that they ought to know where they stand. It is not satisfactory that they should be left with their professional future dependent upon regulations made under the National Health Service, which take no account of their work outside the National Health Service. It is unsatisfactory that the qualifications that are recognised are not statutory qualifications, but are prescribed by the Minister for the time being. That is a very unsatisfactory way in which to deal with a group or profession.
We are experiencing difficulty at present over chiropodists, because my right hon. and learned Friend is now trying to make some use of chiropodists


within the National Health Service, but has no statutory register of chiropodists upon which to work. That illustrates the problem with which these professions are faced.
There was a Private Member's Bill dealing with opticians. If a decision can be taken by the Minister now, it might not be beyond the hope of Parliament that, if not in a Government Bill, in a Private Member's Bill, during next Session, we shall be able to do something for these people.
I hope that my right hon. and learned Friend will not delay any longer his decision on what he wishes to do with hospital pharmacists and what he will do with the professions dealt with in the Cope Report.

6.10 p.m.

Mr. Denis Howell: I am very concerned about several trends in the National Health Service—particularly on the hospital side—which do not augur very well for its future as a social service for the community as a whole. Nothing has so far been said about the talks that we know are going on about free drugs for private patients. I know that it would be out of order to pursue that matter at length, but it is pertinent to ask for an assurance that none of this Supplementary Estimate is intended for that purpose.
Some of us read with a little alarm an inspired leading article in The Times recently which made it clear—whether or not it was true I do not know, but I presume that it was—that the Minister was ready to implement his party's policy that private patients should have free drugs. There would be very grave objection to that, as it would undoubtedly create within the Health Service the old set-up of first-class and second-class patients. All of us on this side would be very strongly opposed to that. If fee-paying patients could have free drugs, their numbers would increase, and they would demand preferential treatment. If they did not get the priority treatment that they were accustomed to in the pre-National Health Service days they could put a financial sanction on medical practitioners—

Mr. Mellish: And priority of admission.

Mr. Howell: And priority of admission, which is something to which I shall refer later. I leave the matter there for the moment, but I think that we are entitled to an assurance on that score.
I am particularly concerned about a trend in the consultant service. It has been apparent for some time that there is a definite move everywhere by these people to change from being full-time consultants to what is called maximum part-time consultant work, and the figures I have quite clearly show that that trend is on the increase. The other day, the Minister told us that between 1955 and 1957 there was an increase of only twenty-six consultants in the Service. I do not think that one can accept that.
It is obvious that whole-time consultants are going on to the maximum part-time basis. This means that nine-elevenths of their time is available for the hospital, and they use the other two-elevenths for their own private purposes. In part, it is an Income Tax dodge. It affords them an opportunity to charge against Income Tax all sorts of expenses that they have not been able to charge before.
I am worried about the control of consultants. As a member of a hospital management committee I feel—without making any personal imputations—that there is no control at all over what they do, how many sessions they work, and the amount of time devoted to each session. Nobody wishes to treat eminent professional men as many working-class men are treated and ask them to clock in and out, but I am sure that the system could be so arranged as to avoid large-scale abuse.
The consultants in the whole-time Service require an increase in salary, and there is justification for giving it to them, but I do not think that the increase should be given, as it were, through the back door. This transfer of consultants is happening everywhere. The Birmingham Regional Hospital Board refused to sanction the move from full-time to maximum part-time work. It wanted to keep its consultants on whole-time service. It wanted the consultants, to whom it pays considerable sums of money, to give all their time to the Service.
The Board went so far as to get the opinion of Mr. Gerald Gardiner, an


eminent Queen's Counsel. His opinion was that, when a whole-time consultant went over to part-time service, that involved new terms and conditions of service. He pointed out that a man who might not have applied for a post because it was whole-time, might apply for it when it was on a maximum part-time basis; that there were then new terms and conditions of service, and that the post should be re-advertised.
I understand that there was considerable correspondence between the Board and the Minister, at the end of which the Board had no alternative but to disregard Mr. Gardiner's opinion. It could no longer hold back the tide of consultants who wanted to cash in on this new maximum part-time consultant work.
This is all very regrettable, and it is a trend that I am very sorry to see. It marks a definite turn in the conditions of the hospital services available to the public. It is, of course, linked up with the whole question of pay beds. One cannot deny that there has been a terrific increase in the number of pay beds, by means of which these doctors can bring in their private fee-paying patients with priority over ordinary members of the public.
In reply to a Parliamentary Question that I asked on 23rd February, the Minister made a remarkable statement. He said:
… I have no evidence that patients urgently needing admission are having to pay to obtain it."—[OFFICIAL REPORT, 23rd February, 1959; Vol. 600, c. 106.]
I do not know what he means by "urgently". If, in the middle of the night, a man has a sudden attack of appendicitis or haemorrhage, I think that he does get urgent attention, and is admitted to hospital. But there are other sorts of medical urgency, and there can be no doubt whatever that in many of those cases a premium is put on ability to pay. It is common knowledge in Birmingham that at the Queen Elizabeth Hospital—a teaching hospital—if one sees one of the consultants attached to it, he will probably say, "I am very sorry that you are a National Health patient. You need this done to you, but you must wait several months. However, if you are prepared to pay £20 a week, you can come in tomorrow".
That is happening all over. It is disgraceful that money should determine admission—

Mr. Julian Snow: Especially children.

Mr. Howell: Yes, especially children. A week or two ago the West Bromwich Executive Council passed a public resolution—for the first time, I think, since the Health Service began—drawing attention to the disgraceful position in West Bromwich in regard to tonsils operations on children. If under the Health Service children go to the hospital to have their tonsils removed they have to wait several months, but if the parents are prepared to pay a fee, the operation can be performed in the very same week.
As I say, it is all linked with the pay-bed system. We had a controversy in the group of which I am a member, when I and others of like mind lost in the debate by one vote. The Marston Green Maternity Hospital had never had a single pay bed, but there was a sudden recommendation that there should be four. Why were they wanted? The reason is that the consultant gynaecologist—a very eminent man, who does a very good job of work—suddenly decided to transfer from whole-time to maximum part-time service, and said, "If I have not any pay beds for patients there is not much point in my transferring." So, for the first time, the Committee has decided that in Marston Green Hospital there shall be four pay beds.
As I said at the meetings of my committee, if there is one branch of the hospital service where private facilities are readily available, it is in the privately run maternity and nursing homes. There are more of these facilities available in this branch than in any other branch of the Service. But then, I am told by the doctors, it is no good their sending their patients to these private establishments, because they are badly equipped; they have not the facilities and equipment which, so the doctors say, they need if one of their ladies who is prepared to pay should need such equipment. That is proof of the argument. As I said at the meeting we had, it is not for the services of a particular specialist that people are really paying. They are paying to have priority in hospital treatment.
The same thing applies when private doctors send patients to see consultants, at a small consultation fee. The doctor, physician or surgeon, decides that some further check is needed with special equipment; perhaps the patient needs a barium meal X-ray or something like that. The patient is sent to the local hospital. Of course, he cannot have priority of treatment as a result of paying for the barium meal X-ray, or whatever it may be, but, armed as he is, after paying his two guineas to the consultant, with a letter introducing him to the hospital, invariably he goes to the top of the queue. Indeed, it is more than that. At a teaching hospital, a patient armed with such a letter has staff and facilities made available at once for him; he immediately has his barium meal X-ray, cardiograph, or whatever it may be that the consultant wants. Here again, people who are prepared to pay receive priority of treatment. In my view, this is quite wrong.
I have asked questions about the consultant services committee in Birmingham. I am told that there is no obligation on a region to have one, but I notice that there is one in Birmingham. It has an absolutely overwhelming majority of medical men, which I regard as quite wrong. In all these things, it is wrong that people should determine their own terms and conditions of service. It does not happen anywhere else.
Another matter which calls for close examination by this Committee is the determination of merit awards. There are 275 consultants receiving an extra £2,500 a year. There are 698 receiving an extra £1,500 a year. There are just under 1,400 receiving an extra £500 a year. These merit awards are determined by a small body in an atmosphere of secrecy. Nothing is made public. Nobody knows anything about it. No member of a hospital committee is ever told how much extra his consultant is receiving over and above his salary. No report is ever made to the public.
Who are the people who determine these awards? What appeal is there against any decision? Consultants whom I know who receive nothing at all are very concerned at the fact that they have no merit award payment. They feel that the situation is quite wrong, that they can do nothing about it and they know

nothing about it. This is a rather serious matter. This is the only branch involving the expenditure of public money for which the House of Commons is responsible—which includes a very wide range indeed—in which money is paid out in an atmosphere of secrecy without anybody knowing anything about it and without any aggrieved person having a right of appeal. It is quite wrong. The whole matter should be carefully examined by the House of Commons.
I do not wish to detain the Committee, so I will make my comments about the teaching service very brief. According to my experience in Birmingham in trying to enlist co-operation from the teaching hospital, it has been almost impossible to get it to take its fair share of the burden of cases, and I am driven to the conclusion that it is ridiculous administratively to have two separate administrations, one run by the regional hospital board and the other run by the teaching hospitals.
This is one of the things that I hope my right hon. and hon. Friends will consider closely when they come back to office. The hospital with which I am connected in Birmingham takes about 50 per cent. of the emergency cases. This can be a fantastic number, especially in the bad weather we have had. We had a little more help from the teaching hospital, this year, but for some years it has been almost impossible to feel satisfied that the teaching hospital, with the high quality of nursing and medical staff it has, is prepared to take its fair share of the ordinary public work.
I am concerned also about the appointment of members of hospital management committees. This is something else which I hope my right hon. and hon. Friends will look at. Indeed, I ask the present Minister to look at it now. Most of the hospital management committees are becoming self-perpetuating bodies. The chairman recommends people, and the people he recommends often find their way to the committee. This system is not a good one. In Shropshire, where we had a lot of difficulty and the Minister set up an inquiry into a very small part of a large number of allegations which we had been making, we found that the composition of the hospital management committee was very bad. Only this year, for the first time, has there been a trade


union nominee on the committee, and this was achieved only after a bitter struggle.
There is a great need for good people in the Health Service on these committees and there is a great need for good leadership. A great deal can be done in this way. The Rubery and Hollymoor hospitals are an outstanding example of what I mean. New wards were provided there for fifty patients at a cost of £15,000, which is £300 per place, far less than the cost of providing new places anywhere else in the Health Service.
Some wonderful modernisation has gone on which is a credit to the leadership there. The re-equipping of the laundry, for example, which was, I understand, opposed by one or two interests, has resulted in much improved efficiency. It now has at least double its previous capacity and the articles are laundered at a cost of about 2¼d. each as compared with a national cost of almost double that. In addition, the people are working in modern conditions. In passing, I should like to tell the Minister that some of the hospital laundries I have seen in the Birmingham region are an absolute disgrace and would not be tolerated for five minutes by a factories inspector if they were in a factory. They have not been cleaned. Their conditions are bad. At times, they drive me to distraction.
I return to the point I made when I began. In the consultant service, it is quite wrong, under any guise at all, that back-door methods of payment should be introduced. If salary increases are needed, they should be negotiated in the open. We should understand the trends in the Health Service. Some of us have very considerable reason to be alarmed at what we see and we hope that the Minister will give more adequate answers tonight than we have had hitherto. If he does not, I hope that my right hon. and hon. Friends will deal with these matters very speedily in the near future when they have the opportunity.

6.28 p.m.

Mr. Julian Snow: During the past few weeks, I have been fascinated by some of the Questions which have been put to the Minister about the cost of drugs to the National Health Service. I have been even more fascinated by some of the replies.
Because I have an interest to declare, as several hon. Members from both sides have had to declare this afternoon, I do not propose to be drawn into the particular matters which have been raised by some of my hon. Friends, except perhaps, to pass on to the Minister two suggestions, which I hope he will not take amiss. In parenthesis, I will say that I have a great admiration for his advisory staff and for his supplies department. I know, as everyone knows, that they are not likely to be unwittingly misled, unless they receive erroneous information from suppliers which they have no opportunity to check.
My first suggestion is that his advisers should take with a little more salt some of the claims made by suppliers of foreign patented drugs who claim that the cheaper equivalents of some of the drugs are, perhaps, not entirely trustworthy or are sub-standard. These claims should be treated as part of a deliberate, commercial campaign aimed at maintaining high prices to the Health Service.
I take issue with the hon. Member for Putney (Sir H. Linstead), who is no longer in his place, because to accuse the Minister and his advisers of buying badly because of the cost of finished drugs, finished in the sense of their forms of application, topical or systemic, is going the wrong way about it. The Minister gave an Answer to one of his hon. Friends recently about the cost of a certain drug. He said that he was not concerned with the cost of raw materials. I do not know who drafted the Answer for him, but I think that he was slightly in error in giving that reply.
If one takes an ordinary tablet which is 99 per cent. a basic drug, one must not consider that basic drug to be a raw material in the general sense of components of other tablets which have large quantities of separate therapeutic agents in them. In other words, a tablet which has a minimum of excipients in it is fundamentally made up of a basic non-variable drug.
I therefore suggest to the Minister that he should have a look at the methods by which costing is done in his Department. There should be an intense examination of basic material costs compared with those obtaining in other countries. But I do not want to go into discussion of this matter too far. I wish rather to deal


with something which I trust is less controversial and which fundamentally affects the cost of drugs to the Ministry, namely, the cost of research. The Minister should accept that in the normal course of events the element of research payable to a patent holder of a drug is about 5 or 6 per cent. on the sale price.
therefore draw the Minister's attention to the prices charged for drugs where the main argument for high prices concerns the cost of research. Over and above that element where research is paid for, terrific profiteering goes on in connection with certain categories and groups of drugs. I must here draw the Minister's attention to the regrettable lack of basic research in this country. I distinguish here between basic or pure research and development research, which is a very different thing.
The Minister will possibly have read an interesting, though in certain ways superficial, article in the News Chronicle of 6th August by Mr. Paul Bareau, in which he mentioned the expenditure on pharmaceutical research in the United States compared with this country. He sail that the annual current return of expenditure in the United States was £43 million compared with approximately £4 million in this country. The Minister probably has a source of information which is better than mine, but I have found it difficult to ascertain how much money is spent on pharmaceutical research in this country. Although the Minister may say that research is not the province of his Department, I suggest that it is inevitably his responsibility now, bearing in mind the fact that the National Health Service is by far the greatest single customer of pharmaceuticals in the world.
In America, the contact between commercial companies' research departments and hospitals, and between commercial companies' research departments and universities is much more intense than in this country; but whereas one sees from time to time, with great, reputable companies like Glaxo, reference to the provision of reserves for pharmaceutical research, it is difficult to discover how much is spent on pure research. I have examined ten main groups of drugs which, without being dogmatic or too precise, are those which I think we should

consider conveniently in the context of this debate.
I refer to antitubercular drugs, poliomyelitis vaccines, diuretics, antihistamines, antidiabetics, sulphonamides, antibiotics, Vitamin B12 which is of increasing importance, psychoactive drugs and prednisteroids. I think that the original pure research, as opposed to development research on seven of those drugs was carried out and patented in the United States. Part of the original research on two of these groups of drugs was carried out in this country. One group, sulphonamides, is almost exclusively of British basic research origin.
I think that this is a relevant point in the debate, because in the long run we are paying for patent rights held outside this country. If only we had spent more money in the past in pure research there would not be this leakage of hard currency and we would not be dependent to the extent that we are at present on having to buy other people's ideas.

Mr. Edelman: Would my hon. Friend explain in what circumstances the recent research carried out on new penicillins has now been transported, as it were, to America, where it is now being developed? Although I accept that research in this country is unduly limited, is it not undesirable that, though limited, it should be, as it were, taken over by the Americans and then developed purely for commercial profit?

Mr. Snow: My hon. Friend has mentioned the new penicillins, and the significance of these is quite extraordinary, as the Minister will know, in the sense that, theoretically, it should now be possible to develop penicillins which will attack specific bacteria which up to now has been resistant. There is also the drug meprobamate. In both cases, the basic research was done in this country, but it appears that we shall lose the development work, as well as the marketing and patent rights in the United States.
What is the reason for this? On an examination of the history of pure research in the United Kingdom, it looks as though it is because companies in this country do not, in the main, appreciate the possibilities. In the case of meprobamate the work was done by a very great English drug house. The man who did the work went to America and before


we knew where we were the drug was patented in the United States and throughout the world by American interests.
It is difficult to discover why the great English drug house of Beecham, having carried out the basic research work on penicillin this new discovery, has allowed the development of it to go to the United States. As far as one can gather, it is because there is spare fermentation capacity in the United States, coupled with the fact that there is a ready-made team of technicians available to American companies. It looks as though the original sorry history of Fleming's great discovery will be repeated and that we shall lose our control of these new penicillin discoveries to the United States. The Minister should consider how his Department can stimulate research so that in the long run, as the pattern of drug invention changes, we do not have to pay vast bills to overseas companies.
The other point to which I want to draw the Minister's attention is this Under Sections 335 to 340 of the Income Tax Act, 1952, an allowance was granted for research purposes. He ought to find out what advantage has been taken of that allowance in respect of pharmaceuticals. I think that he would find that it was surprisingly small. If it is a fact that the National Research Development Council initiates pure research, and has on its staff people who are ex-employees of certain big drug houses, the Minister should be very careful and use his influence, as Minister, to ensure that the possibilities of development are farmed out fairly and not concentrated in the hands of one or two big companies.
I refer to Hecogenin. It is claimed as the invention of a big English drug house, but it is nothing of the sort. The drug house did the development, but the invention was on the initiative of the National Research Development Council. If the Council continues its present policy, the Minister will continue to concentrate in the hands of one or two big companies the power of development which, if it was more widespread, could result in the long run in very great economies to the National Health Service.
I have, possibly, made the Minister a little impatient. I am sorry if I have. I merely ask him to see whether his own Department is capable of looking into basic cost and ensuring that research is

stimulated sufficiently to secure economies for his Department and to treat carefully the claims of certain foreign companies that they are the only producers of pure drugs.

6.42 p.m.

Mr. Arthur Moyle: The first of my few observations is that the problem with which any Minister is faced in connection with the conditions under which consultants, specialists, dentists and the rest are employed by the Health Service depends largely on the measure of agreement which can be established through negotiation with these professional services in relation to the needs of the Service.
We have to carry the good will of all these professional experts who are so essential to the Health Service, whether the Administration is in the hands of a Labour or of a Tory Government, because they are perfectly free to sell their labours in any market of their choice. Having said that, however, I would add that the conditions by which these professional people use the hospital and health services are not a matter for them to decide. The decision should be that of the hospital administration. In that regard, there is much that needs to be dealt with by the Minister in the interests of good administration.
For example, it should not rest with a consultant, however important he may be from the point of view of efficiency of the Service, to decide as a condition of employment that he should have a certain number of pay-beds for his patients. That is a matter entirely for the hospital authority to decide in accordance with the limits and the circumstances of the hospital. It should not in any way rest with either the consultant, the specialist or any other professional employee of the Health Service.
My next point concerns drugs, and from a different aspect to that which has already been raised. I refer to the Health Service patient and not to the private patient. It is out of tune with the Health Service for a person suffering, say, from asthma and for whose recovery or proper treatment a particular kind of drug is essential to be told that the drug which the general practitioner regards as essential for his treatment is not available under the Health Service and is, therefore, a matter of


private arrangement as between the patient and the general practitioner. The fees which are charged for providing the drug and for the treatment is then a private matter as between the general practitioner and the patient concerned. That is entirely wrong.
I consider it an essential ingredient of a common Health Service such as we have that any drug, no matter how expensive, which is considered essential to the proper treatment or recovery of a patient should be available in the Health Service it precisely the same way as a surgical operation.
When I raised the matter with the Minister, I was advised that this was a private matter as between the doctor and the British Medical Association. I say at once that it ought not to be a private arrangement, because in relation to the people who use the Health Service the Minister should have direct control over the terms upon which the treatment or the provision of drugs is made available to the patient. If the Health Service is to do the maximum amount of good to those who use it, no patient should be denied because of cost the right to the treatment that his or her medical adviser considers to be essential.
I come now to the point so well made by my hon. Friend the Member for Birmingham, All Saints (Mr. D. Howell). There is one regard in which we must do something to improve public relations. If we write to the Minister and say that we have reason to believe that prior 'treatment is given to a paying patient, whether a child seeking an operation for defective tonsils or a patient requiring some other treatment, and we say that the paying patient is known to have had prior admission over the non-paying patient, the Minister at once adopts—I do not blame him—a very cautious and self-satisfied attitude by telling us that in cases of urgency no such priority exists which militates against the proper interests of the non-paying patient.
The Minister can send us letters containing that well-known phrase as often as he likes, but immediately we deal with these matters in our constituencies we have case after case brought to our notice by which we are convinced that prior consideration is conceded to paying patients. Can he not do something about this administratively? While

admitting the privilege of the paying bed or the paying patient, is it not possible for the Minister, in present circumstances, to be able to issue a directive to the hospital authorities with a view to placing it beyond any doubt that no paying patient has priority of consideration over the rest of those who seek to use the Health Service?
The Minister will recall the vexed controversy which arose last year concerning rates of pay and the alleged intervention of the Minister which prevented the operation of a decision of the Joint Whitley Council in regard to clerks in the Health Service. I do not want to refer to that unduly, but I do want to say to the Minister that, having regard to the need for good industrial relations, I think it is essential that, however great the liability of the Minister is in regard to Health Service expenditure, neither he nor his representatives must give an impression through the Joint Whitley Councils in the Health Service that he alone decides these issues of rates of pay and conditions of service.
It is not good from the point of view of good relations that it should be assumed that no matter what the representatives—his own representatives and those of the local authorities and the hospitals—may do in the field of negotiations as to the right rates of pay and conditions of service, the Minister can intervene and say that the decisions reached are not acceptable. In other words, we do not want to make a sham of the negotiating machinery in the hospital service but to give it a sense of reality by conveying to those who are engaged in this very delicate work of adjusting rates of pay and conditions of service a feeling that not only have they responsibility but also power of decision, in the issues that come before them.
I ask the Minister to look at this aspect of the matter. Collective bargaining is important, but good will in the expression of it is much more important. Finally, I ask him whether the time has not come when he should review the existing machinery of collective bargaining in the Service with a view to simplifying it and making it much less cumbersome and much more efficient in discharging the task of determining rates of pay and conditions of service of those engaged in the Health Service.

6.52 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Richard Thompson): We have had our usual fairly discursive, and I think useful, debate on this Supplementary Estimate, and, very largely, the theme running through it has been the question of drugs. It might be for the convenience of the Committee if, first, I deal briefly with some of the lesser but not unimportant points made by hon. Members during the debate, and dealt rather more fully with that question, to which several hon. Members have made contributions, later in my remarks.
First, may I say how greatly I appreciate the welcome given by the right hon. Lady the Member for Warrington (Dr. Summerskill), in her turn, for the improved system of hospital costing which we now have in the Health Service? Nobody pretends that a better capacity to arrange figures is a substitute for all the other things we should like to see, but there is no doubt that the introduction of this system has been enormously beneficial. I think that we shall get a great deal of benefit out of it in future, because unless we know with some precision what different activities are costing in different hospitals, we lack the means of a proper comparison of one activity with another. Now that we have that system available—and it is a tool of management, no more—I shall look forward to very much improved administration as a result of it.
The right hon. Lady asked me one or two specific questions which perhaps I might deal with now. She wanted to know how we were getting on with implementing or otherwise the 10 recommendations of the interim Report of the Hinchliffe, Committee. I am very pleased to be able to tell her that we are making good progress there. We have either completely or substantially accepted seven of the 10 recommendations. There was one which has been referred to the Royal Commission on Doctors' and Dentists' Remuneration, which is now sitting, and that can hardly be settled until we have its report before us.
There were two which were discussed further by the Hinchliffe Committee and the Pharmacopoeia Commission. So we can honestly say that we have moved swiftly in that matter, though, of course,

the final report of the Hinchliffe Committee is still to come. I think that we have done what was possible on the information available to us now.
The right hon Lady's next point was on the Bradbeer Report, and on that matter she had an exchange of view with my hon. Friend the Member for Putney (Sir H. Linstead). As the right hon. Lady knows, the Report was published and has been widely studied in the hospital service. All this was some time ago. Much of its contents was generally acceptable and is normally practised now, but some of the suggestions were of questionable value, and none of this advice appeared to the Minister of the day, or to my right hon. and learned Friend, as sufficiently novel or weighty as to warrant special action to draw the attention of hospital authorities to it.
On the specific point which the right hon. Lady raised on medical administration in general hospitals, the Committee opposed the appointment of medical superintendents, but supported the establishment of medical staff committees, at any rate, for medical staffs themselves, but declined to lay down any general pattern. It suggested an alternative, applicable, we believe, in most of the large general hospitals—which is going fairly close to what the right hon. Lady herself said—in the appointment of one consultant to be selected generally by the medical staff committee, the hospital management committee and the regional hospital board from the medical staff, and to spend some part of his time in administrative work.
My right hon. and learned Friend has thought it wise to leave hospital authorities to reach their own decisions and to experiment in this way, and some, in fact, have done so. I am not currently aware that hospital costs are necessarily lower in those hospitals where such an appointment has been made, but, probably, with the better costing machinery which we now have, we may be able to say more about that a little later.
My hon. Friend the Member for Devizes (Mr. Pott) spoke of the problem of the small maternity units which were having great difficulty in carrying on because of the shortage of hospital midwives. It is true that over the past few years the number of practising midwives in hospitals and domiciliary work has actually changed very little, and the shortage which exists


is caused by the rising birth-rate, and the lack of sufficient new midwives remaining in the profession in the hospital service.
The number of new recruits coming forward and taking the training is, on the whole, satisfactory to maintain the numbers, but there is a very considerable wastage because not a sufficient number of them practise. The matter has received the urgent attention of the sub-committee of the National Council for the Recruitment of Nurses and Midwives. A number of suggestions for making the profession of hospital midwifery more attractive were made, and these have recently been commended by a circular to the hospital authorities.
In addition, arrangements are now in hand for the problem to be studied in greater detail on the spot by medical and nursing teams from my Department, which will visit the areas where the shortage is most acute to advise on remedial action and obtain more information on local difficulties, as a guide to future policy.
My hon. Friend also mentioned the question of remuneration, and asked whether some special differentiation could be introduced to attract these people into the worst staffed areas. I can only say that a scheme is at present tinder consideration by the appropriate Whitley Council, and that, while I accept that this has a bearing on the problem, though not a strong one, it is not the only incentive that could be applied. I hope that what I have said will show that we regard the matter very seriously. The steps that we have taken to apply expert knowledge and experience to the subject and our intention to benefit by and apply the result of these inquiries will be evidence of that.
The hon. Member for Manchester, Exchange (Mr. W. Griffiths) does not seem to be in his place. Therefore, I cannot tell him the particular piece of information which I think he might have found helpful or valuable to him. My hon. Friend the Member for Bromsgrove (Mr. Dance) raised the question of the closing down of a hospital house committee in his division. He referred to the indignation which this has seemingly caused locally. I can well understand his feelings on this matter but, of course, it is one on which

there is no immediate ministerial responsibility. It is a matter which must be ironed out by the hospital management committee which took this step in the first place, and that committee will probably wish to see the regional board about it if the dissatisfaction to which my hon. Friend refers is as great as he says it is.

Mr. Snow: On that point, which is of general interest, is it not a fact that house committees are conducted on rules laid down by the Ministry and that those include authority to the regional board to suppress them if necessary? Does not that stem from the Department?

Mr. Thompson: It might be said that everything in the Health Service stems from the Minister in the end, but we have no immediate responsibility for the appointment of people to a house committee or, indeed, to hospital management committees.
The hon. Lady the Member for Wood Green (Mrs. Butler) asked one or two specific questions about protection against ionisation. My right hon. and learned Friend has urged hospital authorities to give effect as soon as possible to the code of protection against the effects of radiation. The cost of doing so must necessarily come, out of their own resources, that is, the sums for hospital revenue and capital voted by the House of Commons. I am sure that the importance of giving this development high priority is widely appreciated.
The hon. Lady also asked whether the increased sums provided in the Supplementary Estimates which we are now discussing include increased remuneration for radiographers and physicists. I am advised that an agreement on the remuneration of physicists has just been reached on the Whitley Council and is about to be submitted to my right hon. and learned Friend. No provision was included in the Supplementary Estimates, but, of course, effect will be given to the increase if it is approved. Negotiations are proceeding on the remuneration of radiographers and are to be continued at a Whitley Council meeting as early as tomorrow.
The hon. Member for Birmingham, All Saints (Mr. D. Howell), the whole of whose speech, unhappily, I had the misfortune to miss, raised mainly the


question of part-time and whole-time consultants. The Guillebaud Committee considered that under existing conditions, that is, in 1956, there was a valid case for the retention of part-time consultant appointments in addition to whole-time appointments, but that the financial arrangements should not be such as to induce a consultant to seek a part-time rather than a whole-time appointment. Evidence has been given on the matter to the Royal Commission on Doctors' and Dentists' Remuneration and any observations that the Commission makes in its Report we shall await and study with a good deal of interest.
In the present circumstances, my right hon. and learned Friend was advised that if a consultant with the agreement of his board, changes from whole-time to part-time work and there is no substantial change in duties, there is no need to advertise the post when the contract is varied by the parties. I am sure that the hon. Member appreciates that in this matter we have an agreement with the medical profession and it is inadvisable to seek any modification or adjustment of that while the Commission is still sitting. When we have the Commission's views on it we shall be able to look at the matter again.
I think that it would be now appropriate for me to say something about drugs in the National Health Service, a subject which has formed a considerable part of the debate. It might be appropriate if I started off by refreshing the Committee's recollection of some of the steps which we take or are contemplating taking to make doctors and hospitals cost-conscious, in particular with regard to the cost of drugs and medicines. I realise that that is not the whole of it and that we have to deal with the cost of the drugs themselves. There are two questions here—whether prescribing is extravagant and whether we are paying too much for the drugs. Some of these matters, of course, are familiar to hon. Members who follow these things closely.
The principal means that we have used for this purpose has been our old friend the "Prescriber's Notes". These notes, which go out roughly every quarter were originally prepared for general practitioners, but since January, 1953, we have issued them to regional hospital boards, boards of governors and teaching hos-

pitals for distribution to their medical staff. The Report of the Joint Committee on Prescribing has been sent to hospital authorities, who have been asked to distribute copies to all hospital doctors and pharmacists.
From time to time, the Chief Medical Officer of the Ministry has sent personal letters to all doctors in the hospital service asking for their co-operation in reducing prescribing costs. Besides asking doctors to have full regard to the Report of the Joint Committee on Prescribing, these letters have dealt with many points including the danger of extravagant use of antibiotics and vitamins and the need for care in prescribing proprietary drugs. In addition, clinical teachers, since 1953, have been asked for their help in instructing young doctors in the cost of prescribing.
The Sub-Committee on Hospital Pharmaceutical Services, under the chairmanship of my hon. Friend the Member for Putney, spoke in its Report of substantial economies secured without prejudice to treatment through the investigation by the medical committee of the current prescribing practice. The Sub-Committee said that where this had not been done it might now be put in hand with periodical reviews on subsequent occasions. The Sub-Committee's Report was brought to the notice of regional boards and boards of governors by circular, dated 3rd March, 1955, which recommended regional boards to set up pharmaceutical advisory committees to advise them of any steps necessary to make the service efficient and economical.
In March, 1955, also, a circular letter, signed by an Administrative Officer, was sent to hospital boards and management committees suggesting methods by which economies might be achieved, among other things, in the preparation of 30 or so of the most expensive items. The medical committees of the hospital concerned would then be asked to examine the prescribing of these items to see whether economies could be made without prejudice to the treatment of patients. The second measure advocated was special attention to the possibilities of economies in the use of surgical dressings and the prescription of vitamins, and the third was the setting up of a committee on which medical and nursing staff were represented to make sure


that medical advice was readily available on the best use of and the storage and handling of drugs.
Then again, in 1957, the Chief Medical Officer of the Ministry sent a letter to the chairmen of the group medical advisory committees asking for their cooperation in connection with the introduction of improved hospital costing arrangements, about which I said something earlier. This letter stated:
If the figures are produced with care and sensibly interpreted, hospital costing can help those responsible for running the hospital service to secure the most effective use of the limited resources available.
In accordance with those recommendations of the interim Report of the Hinchliffe Committee which concerned the hospital service, and to which I have referred, we have arranged for the issue of the alternative edition of the British National Formulary to all clinical students and hospital doctors. The right hon. Lady made a point of that; she wanted to be sure that people coming into medicine were seized of the importance of due economy in prescribing. Those are steps, some quite well known, which show what we do to try to keep economy of prescribing constantly before those in the hospital service.
Now I will turn to the other side of the picture, what we pay for the drugs we use, and, in particular, the very costly antibiotics, corticosteroids, and drugs of that kind.

Mr. Moyle: Would the hon. Gentleman deal with my point about the Health Service patient who is charged for the provision of a drug which a general practitioner considers is essential to her proper treatment? I asked what is the basis on which the Ministry acts which precludes certain drugs from being made chargeable to the Health Service and what is the procedure in this connection? That question concerns a case I took up with the Minister, with which the Parliamentary Secretary dealt, and he said that it was quite in order and was a matter between the practitioner and the B.M.A.

Mr. Thompson: It is competent for a doctor to prescribe any drug considered appropriate for the treatment of his patient. We do not tell the doctor that he must prescribe this or the other drug.
That is something we should never do, and we do not seek to do it. However, I shall be able to give the hon. Gentleman a fuller answer to his question if he will allow me to refresh my memory of that case.
Turning to the speech of the hon. Gentleman the Member for Coventry, North (Mr. Edelman), he was concerned, among other things, about the cost of the polio vaccine which we have been using in such quantities in connection with our original and expanded programme. The original plus the Supplementary Estimate provided for an expenditure in England and Wales of £2·7 million, which was divided roughly as follows. About £900,000 for the British vaccine, which the hon. Gentleman will remember was relatively scarce—and there was, consequently, less of it—and £1·8 million for American and Canadian vaccine. The price we are paying for British vaccine per litre at present is actually substantially higher than the prices we have recently been paying for American or Canadian vaccine.
We should bear in mind, in this connection, the fact that the British vaccine is not identical with the American or the Canadian, and, also, that the American firms have been in production for several years. During this time their prices have been reduced as production increased. British firms are only now coming into substantial production after considerable difficulties, and this may account for the difference. We have not purchased poliomyelitis vaccine from all the American manufacturers, of whom the hon. Gentleman gave us a list at one point. But I can tell him that we did not receive identical quotations from those from whom we bought supplies. There were three firms involved. I hope that this purely factual point will help the hon. Gentleman on the question of what we pay for the vaccine and the position as between the English and the American firms.

Mr. Edelman: I am obliged to the hon. Gentleman for his analysis of the various suppliers, but he has not really answered my point. It was whether the contracts were put out to tender to British manufacturers and whether the British manufacturers quoted a uniform price for the poliomyelitis vaccine.

Mr. Thompson: I can assure the hon. Gentleman that they are not uniform. In the case of the British manufacturers we were in the situation that last year we could not get anything like as much from them as we would have wished to purchase, so we were purchasing relatively small quantities, but I can tell him that the prices were not uniform.

Mr. Snow: I am sorry to interrupt the hon. Gentleman again. When he talks about British manufacturers, does he include American subsidiaries in this country who have produced vaccine?

Mr. Thompson: I would say, "No." I put it that way because the two firms from whom we have received our supplies up to now are British firms. There is another firm which is an American subsidiary, I understand, coming into production, but we have not taken anything from it yet.
Now perhaps I can deal with the point which the hon. Member for Coventry, North made at some length about mecamylamine. Up to February, 1957, this drug was imported in its finished state, but in fairly small quantities, from the U.S.A. and it is now made here by a British-based subsidiary of the United States firm. A patent has been applied for it. If it is granted, it will run for sixteen years and the drug will be available in proprietary form only from the manufacturers or from anybody who may have a licence to manufacture it.
The Controller of Patents, under Section 41 of the Patents Act, 1949, can order a licence to be granted on terms which seek to secure that the medicine shall be available to the public at the lowest prices consistent with the patentee's deriving a reasonable advantage from his patent rights. If an application is granted in this case, any British or other firm may apply for a compulsory licence to make mecamylamine hydrochloride. So far no one has come forward.
I have no figures of the cost to the Health Service of this drug supplied to hospitals. The manufacturers say that hospitals are the principal users here. Its importance lies in the fact that it is much the most powerful of three or four valuable drugs used in the treatment of hypertension and, as I understand, it is the strength factor which commands its

use in certain cases. It is classified by the Cohen Committee in category I as a "new drug of proved value not yet standard."
With certain exceptions, the voluntary price regulation scheme agreed between the Health Departments and the Associated British Pharmaceutical Industry applies to all proprietaries in categories 2, 3 and 4 of the Cohen Committee's classification, and these comprise 90 per cent. by value of all proprietaries available on National Health Service prescription. The scheme does not apply to products so available for less than three years, and, therefore, in practice, it applies to roughly 60 per cent. by value of all proprietaries.
This scheme, I think, has a considerable bearing on what the hon. Member for Coventry, North would like us to do. Its duration is from June, 1957, to June, 1960, and before the latter date its working will be reviewed in all its aspects. We shall not wait until June, 1960, before considering the lessons to be drawn from it. We shall study in good time the information to hand, to see whether the scheme should be renewed, whether it needs to be improved, or what should be done.
Mecamylamine, to which the hon. Gentleman referred, is a category I product and has also not yet been available for three years on National Health Service prescription, so it is not price regulated. On reclassification by the Cohen Committee in categories 2, 3 or 4, its price will become subject to regulation under the scheme. Of course, if it is replaced by a new product and goes out of favour that is a risk which the manufacturers have to take. It seems to me that it was a little unrealistic of the hon. Gentleman to take the raw material cost, which he did, compare it with the price of the finished product and call the difference gross profit.

Mr. Edelman: The hon. Gentleman has gone into this matter in great detail and I am much obliged to him for doing so; but he will recall that I submitted to him a detailed analysis of the cost of this drug and of alternatives which could be supplied. I think that the comparison showed that, on the basic figures as presented to him, the manufacturers at present were making the profit to which I referred—1,990 per cent. I should like


to establish, first, that the hon. Gentleman has seen and does accept those figures as presented to him.

Mr. Thompson: That was the point I was making. I have seen the calculation of the hon. Gentleman—indeed, I replied to his letter—but I do not necessarily accept the arithmetic.
As I was saying just before his intervention, I think that it is unrealistic to compare raw material costs. After all, we ought to know whether the raw material has the same potency and the same efficacy as whatever may be used in the finished product over here. It is unrealistic simply to deduct a figure for raw material cost from the price of the finished product over here and call the difference gross profit. It leaves out of account processing, packaging, cost of research and marketing, and also the possibly short life of a drug.
I would not accept the hon. Member's view that all these drugs have a life of only two or three years. I think that many have a life longer than that. But it is a factor, when putting a price on these drugs, that if they are likely to be superseded in a very short few years it follows that the development expenditure which went into them, plus all the development expenditure which went into other drugs which did not find acceptance, has to be recouped in a much shorter time. Therefore, it is unfair to single out one product and make an oversimplified calculation based on the cost if its raw material alone. It is with the factors I have mentioned in mind that a free period is allowed under our voluntary price regulation scheme.
Nevertheless, all this is public money, and my right hon. and learned Friend is closely concerned to ensure that reasonable prices for new drugs in category 1 or categories 2, 3 or 4 after the three-year period should be secured. I think that the best thing that we can do is to review this scheme very thoroughly, as I have said we shall, before it comes to its end to see whether it is fulfilling its function and whether there are grounds for the kind of allegation that the hon. Gentleman made—which, while not accepting, I certainly take seriously—and also to see whether there is a case for replacing or improving it.
On the question of American subsidiaries as a whole, I would say that if new drugs are not manufactured in Britain the alternative is to import the finished product; and that is always more expensive. It is not right to think of these firms as plunderers. Foreign firms have sunk considerable sums in setting up appliances here and we derive a valuable export trade and thriving industry from it apart from the benefit to the National Health Service of having these drugs which would otherwise be unobtainable from home production. I would hope that nothing that is said in this Committee would have the effect of frightening away foreign firms who are prepared to export their brains and sink their capital in the drug industry, supplying employment to people in this country.
We must not allow the rise in the drug bill to obscure the fact that the increasing use of these drugs has led to much quicker recovery of patients and that more patients have been treated more cheaply at home rather than in hospital, and that the more rapid turnover of hospital beds has been possible. Unless there were to be some restriction on the freedom of doctors to prescribe as they think best, we cannot limit the use of new drugs, although we can and do, in the way I have described, keep the need for economic prescribing constantly before them.
I should like to say a word on research, because the hon. Gentleman the Member for Lichfield and Tamworth (Mr. Snow) had a word to say on that. The drug industry is spending about £4 million annually on pharmaceutical research. It is of two types, long-term fundamental, which can only be undertaken by the largest firms, and short-term progress and development research. A measure of the work undertaken is shown by the fact that, on average, about 1,000 new substances are synthesized to produce one for the market.
Each firm which does research on any scale has a research team or teams working as a closely integrated unit. For instance, a large firm may employ over 100 graduates. Research in the industry is not into a single product or allied group of products, as in some other industries, but into a wide range of substances designed to have quite different effects on the human body.
Central research which, I think, was implicit in something that the hon. Gentleman said—

Mr. Snow: That is the very opposite to what I said.

Mr. Thompson: I am happy to have that correction. The hon. Gentleman may remember that I came in during the middle of his speech. If he agrees with me that research should not be over-centralised I should have thought that one of our protections in seeing that we pay an acceptable and reasonable price for these new drugs, which we so badly need, was the existence of a number of firms capable of carrying out this kind of work independently, although that inevitably means a certain amount of overlapping.
May I conclude by saying one or two things which I think the Committee would like to hear about certain developments which are pending. My right hon. and learned Friend attaches the maximum importance to getting the best possible value for money in the National Health Service. Hon. Members may remember that he referred in the debate on 30th July to his intention to set up a body to assist in the development of efficient techniques in the Service.
I am very happy to tell the Committee that Sir Ewart Smith has agreed to serve as chairman of the council which the Minister is setting up. We are very fortunate indeed to have a man of his calibre and experience and holding an almost unique position in this field of work study to help us in this way. My right hon. and learned Friend hopes to be able to announce shortly the names of the other members. One of the first problems which, no doubt, the council will wish to consider is the best method of extending efficient studies in the Health Service.
My right hon. and learned Friend told the House a few months ago, on this same theme, that he had accepted an offer from the Management Consultants' Association to demonstrate, by studies in four hospitals, what economies could be secured in the Service. He has just received the first report from the four hospitals and is studying it. Further more detailed study will, however, be

necessary to complete this particular exercise.
We shall shortly be issuing guidance to hospital authorities designed to improve the methods of selecting candidates for administrative appointments in the Health Service. These include the establishment of registers of officers suitable for promotion and the inclusion in appointments committees of assessors drawn from outside the employing authorities. It is hoped, in this way, to reduce the disadvantages attached to the multiplicity of employing authorities and work towards the evolution of common service standards.
The present manpower control in respect of non-medical staff of hospitals is to be removed and hospital authorities are to be given wider delegated powers. We are proposing to establish a small team in the Ministry whose job will be to visit hospital authorities and report on their staffing situation in order to facilitate the spread of good management practices and promote the economical use of staff.
I hope that what I have said will show that we are not in the least complacent about the enormous sum of money which we are asking the Committee to sanction. We have very good plans here. Plans and advice are now being supplied from the various bodies which have been studying important problems and we intend to apply those plans and advice with the utmost enthusiasm and speed. I hope that in all the circumstances the Committee will feel that this money is being worthily spent and that it should be voted.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £16,589,706, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the provision of a comprehensive health service for England and Wales and other services connected therewith, including payments to Northern Ireland and the Isle of Man, medical services for pensioners, etc., disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, certain training arrangements including certain grants in aid, the purchase of appliances, equipment, stores, etc., necessary for the services, and certain expenses in connection with civil defence.

Vote 11. National Health Service, Scotland

Motion made, and Question proposed,
That a Supplementary sum, not exceeding £2,376.500, be granted to Her Majesty to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the provision of a comprehensive health service for Scotland and other services connected therewith, including medical services for pensioners, etc., disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, certain training arrangements, the purchase of appliances, equipment, stores, etc, necessary for the services, certain expenses in connection with civil defence, and sundry other services.

7.33 p.m.

The Joint Under-Secretary of State for Scotland (Mr. Niall Macpherson): In introducing the Supplementary Estimate, I wish, first, to express my regret that my right hon. Friend the Secretary of State and my hon. Friend the Joint Under-Secretary, the hon. Member for Craigton (Mr. J. N. Browne), who are responsible for the Health Service in Scotland, are at resent in the care of the Health Service in, England, and cannot be present. I am, therefore, in this connection making a somewhat reluctant debut at this Dispatch Box to introduce this Supplementary Estimate.
I wish first to explain the reason why the Supplementary Estimate had to be put down. This Estimate seeks additional provision mainly for four services. First, the hospital, specialist and ancillary service, for which just under £700,000 is required for the acceleration of the programme of works, and about £300,000 for additional running costs; secondly, for the pharmaceutical service, with £641,000 more; thirdly, the remuneration of general medical practitioners, with a further £220,000, and, fourthly, the local authority health services, with an extra £185,000 net. There are smaller increases under seven other heads, amounting in all to £325,100, and there is an unexpected deficiency of £68,800 for appropriations in aid. Relatively small savings under three other heads offset this increase by £57,400, making a net additional sum asked for of £2,376,500.
The largest item in the Supplementary Estimate is the additional sum of just under £700,000 for the accelerated programme of hospital works. As my right hon. Friend announced on Tuesday, in

answer to a question from my hon. Friend the Member for South Angus (Sir J. Duncan) a sum of £1,150,000 was made available by the Government to Scottish hospital authorities in the late summer and autumn of last year with the object of relieving unemployment by accelerating the programme of minor capital works, building maintenance and the replacement of equipment. The amount of this sum falling in the current financial year is the £700,000 or thereabouts which I have mentioned.
The regional hospital boards are giving, so far as possible, special consideration to the needs of hospitals in the unemployment black spot areas including Western Clydeside, North Lanarkshire, Aberdeen and Dundee. They have been asked to use the money to carry out necessary works and to purchase equipment, particularly for hospital laundries, which will improve the efficiency of the Service or lead to economies in future running costs. The provision is included in the appropriate capital and revenue subheads of the Estimate: £394,000 in advances to regional hospital boards on capital account and £273.000 on revenue account, the balance being in the subheads for equipment and the ambulance service. The additional sum of approximately £300,000 for the running costs of the hospital service is required mainly to meet the cost of salary and wage awards made after the original estimates were framed.
The second largest item in the Supplementary Estimate is £641,000 for the pharmaceutical service. While the number of prescriptions dispensed by chemists is expected to be about 1 million fewer than estimated, the average cost of ingredient continues to rise. The main reason for this is the greater use by family doctors of the more expensive drugs such as the antibiotics and corticosteroids about which my hon. Friend the Parliamentary Secretary to the Ministry of Health has been speaking.
There are two reasons for the extra amount of £220,000 for general practitioners' remuneration. The first is that an advance payment is being made earlier than expected on account of the balance on the central remuneration pool for 1957–58. The other reason is the interim award of 4 per cent. from 1st January, 1959, made pending receipt of the Report of the Royal Commission on Doctors' and Dentists' Remuneration, offset by a


saving on recalculation of the 1956–57 central pool balance.
The additional £185,000 needed for tile local authority services is mainly attributable to expenditure on clinic and home help services as well as to salary and wage increases. In some respects, therefore, for the reasons I have given, the original calculations on which the Estimates are based have had to be revised.
That is a brief description of what ate Supplementary Estimates are for, but before I conclude, I should like to mention two other points. The first is in connection with the hospital service, which is the biggest single item in the National Health Service Vote and makes the largest call on the Exchequer. The Supplementary Estimate arises because the greater part of the expenditure is on salaries and wages. There have been increases, as I have said, in line with the trends elsewhere, for which we have to make provision.
Apart from this, we have this year achieved a remarkable result. A year ago, when the £ was under pressure and expenditure had to be severely restricted as part of the Government's measures to protect the £, we set the hospitals in Scotland the task of saving about £400,000 on their annual expenditure. That was to be their contribution towards stability. That saving has been very largely achieved by careful economy, as the result of reductions in demand and appropriate action, notably in tuberculosis treatment in hospital.
Within the total provided, it has still been possible to staff and to bring into service the new buildings that were completed during the year, and other improvements have been made as well. Naturally, my right hon. Friend and the hospital authorities were sorry that they had to restrict expenditure in this way, but it was necessary. Now that these financial difficulties are behind us we look forward in the next financial year to improvements and extensions of the Service on a much greater scale than has been possible hitherto. It is still sometimes said that there is too much waste in the hospitals and no proper financial control. The measures taken this year show that there is control. My right hon. Friend and I are grateful to the hospital authori-

ties for their excellent co-operation with us.
The other topic I would touch on briefly is the pharmaceutical service. Once more we have to make provision for in creased expenditure on what is commonly known as the drug bill. The important factor giving rise to the Supplementary Estimate is that the increase in the cost of prescriptions has exceeded our expectation. Expenditure on the pharmaceutical service is a complex matter. There is the prescribing practice of the doctor, the cost at which drugs are bought from manufacturers and the payments to be made to the chemists. During the year we have agreed on changes, as my hon. Friend the Parliamentary Secretary to the Ministry of Health has already announced, which will reduce the burden on the Exchequer of the cost of drugs and the payments to the chemists.
There is a general feeling that more attention should be given to the actual prescriptions the doctors write, both in hospitals and in general practice. Does the doctor make the right choice and prescribe the right amounts? Does he know enough about drugs and about the cost of them? These and other aspects of prescribing practice were referred by my right hon. Friend to a Departmental Committee under the Chairmanship of Sir James Douglas and consisting, properly, mostly of doctors. It included some of the most distinguished doctors in Scotland, both in the hospital service and in general practice.
The Departmental Committee has just submitted its Report, and my right hon. Friend is arranging to publish it as soon as possible. It made a whole series of recommendations which we shall have to study and to discuss with the medical profession and others concerned. It has not hesitated to criticise, and if I may put it in this way, same people may find the medicine it prescribes rather unpalatable. We wanted a full report on this difficult subject from a committee composed mainly of doctors and we are very glad to have it. I think the Committee would want to know that, and we shall all study the Report carefully. I will take this opportunity, on behalf of my right hon. Friend and of my hon. Friend the Member for Glasgow, Craigton to thank Sir James Douglas and his committee for their labours and for producing with no delay this valuable Report.
With this explanation I hope that the Committee will be prepared to approve this Supplementary Estimate.

7.45 p.m.

Miss Margaret Herbison: I must first of all thank the Joint Under-Secretary of State for his explanation of this Estimate For both the Scottish Ministers who are in charge of the Health Services to be off ill is very much like the Minister of Health and his Parliamentary Secretary being ill and asking the Minister of Education to come to present the Supplementary Estimate We are all grateful to the Joint Under-Secretary of State for doing his very best to give an explanation of this Supplementary Estimate.
We are being asked to vote a sum of more than £2¼ million. The Joint Under-Secretary of State has said that the hospital service is the biggest single item, that is, if we take in with the hospital service the ambulance service and the other ancillary services. If we take this single item, the biggest is the pharmaceutical service at £641,000. My right hon. Friend the Member for Warrington (Dr. Summerskill) dealt with this subject very fully on the English Supplementary Estimate and I propose to say very little indeed on the matter, not because I do not think it is of the greatest importance that we should have savings wherever we can and not because I do not think that many people would feel that savings can be made, but because my right hon. Friend dealt so fully with the subject. Some of my hon. Friends may want to deal further with this Scottish point.
I want to make only one point. The Minister said that prescriptions had been fewer than had been estimated for, but the cost of the ingredients had been very much higher. Would he tell us when he replies to the debate—I understand that the Joint Under-Secretary of State is also to reply—what is now the cost of the prescriptions?
I want to deal with the Supplementary Estimate for the pharmaceutical service, which shows a saving. Had it not been for this saving we should be voting more than £673,500. We are told that the saving, in dispensing fees and rota payments, was £83,000. I want to get information on this subject, if possible.
In Scotland we have had experience of this rota system being stopped by executive committees in some areas. The Joint Under-Secretary will know about one of the cases that I took up at Newmilns in my own area. When the rota system is stopped, no chemist's shop is open at any time on Sunday in the area. When there is illness in the home on Sunday and a doctor has to be called in—which usually means some serious illness—a member of the family has to travel a fairly long distance to get the medicine that is on the prescription. That causes very great inconvenience in a home that is already suffering from the illness.
The Government first made the prescription cost 1s. and then made the prescription cost 1s. per item. This bears very heavily when sickness comes. It is a tax on the sick man or the sick woman. By taking away the rota system in some areas it means that not only have people to pay these extra shillings for the prescription, but they have to pay extra money for travelling from the village, in sonic instances long distances, to get the medicine from the chemist.
I ask the Joint Under-Secretary to have a word with the members of his Department and with the Secretary of State to see if the right hon. Gentleman will ensure that where an executive council has stopped the rota system—it seems that quite a number have—there is no great hardship, as there was in my constituency until, after investigation by the Secretary of State, the rota system was started again.
I want to deal with the ambulance service, which comes under Subhead D.7. There we are asked to vote £69,000, of which £17,000 is for the purchase of vehicles and equipment. The Joint Under-Secretary told us that, because of the financial difficulties of the Government, the hospital services were asked to save as much as they could and there was a saving of £400,000. I wonder it some of that was a real saving. That is why in this instance I want to examine the matter. My hon. Friend the Member for Motherwell (Mr. Lawson), put a Question to the Secretary of State on 23rd February. He asked about ambulances that had been ordered on behalf of the St. Andrews and Red Cross Scottish Ambulance Service in 1958. This


was the Answer given by the Secretary of State:
The Joint Central Committee for the Scottish Ambulance Service advised me that it was urgently necessary to provide additional vehicles to avoid a breakdown of the Service during the winter."—[OFFICIAL REPORT, 23rd February, 1959; Vol. 600, c. 119.]
That was a very serious position for our ambulance service to get into. It had urgently to order new ambulances—I take it that this £17,000 is to pay for some of them—because there might be a breakdown in the service. Would that breakdown have been due to these economies which were imposed on the hospital service by the Government?
There is another point to which we on this side of the Committee must refer. When it was discovered that there would be a breakdown of the ambulance service what did we find? Instead of the order being placed with a Scottish firm, although we are always complaining of the very high rate of unemployment in Scotland compared with that in England, the order went to an English firm. Scottish firms were not even allowed to tender, but the order went to an English firm without any tendering at all. We criticise the Government, first, that when they insisted on savings in this instance they were not real savings, and that they might have been a grave danger to our hospital service and to the lives of the patients. Because they are insisting on this saving the Secretary of State had to say, "We had not time to put this out to tender and we just gave the orders to an English firm." On all these complaints, the Secretary of State deserves very great criticism.
I come to Subhead K.1. and the grants to local health authorities. We are asked for an extra £45,000. We are told that this is:
Additional provision required mainly because of extension of clinic services.
If the Joint Under-Secretary can give me the information, I should like to know exactly where these extensions were. If the hon. Gentleman cannot give the information now I shall understand and perhaps he will give it later in writing. In my area the population is scattered and the villages are some distance from the towns. For a considerable time we have been trying to get adequate clinic facilities in some of the villages. Adequate clinic services cover a very wide

field and make a great difference to the health and to the spirits of people in some villages.
Another point I wish to raise is the Supplementary Estimate for which we are asked for the midwifery service, amounting to £8,000. We are told that this is
to meet the cost of additional staff.
The Joint Under-Secretary may be aware of a debate held in the House on this matter. I ask him if by the spending of this £8,000 he feels that we shall have an adequate midwifery service in every part of Scotland. My information is that that is not so. There are complaints about salaries and complaints about promotion. When the Parliamentary Secretary to the Ministry of Health dealt with this question, he showed that, although many trained, they did not actually work as midwives. That may be due to the amount of salary, to blocked promotion and general conditions. I hope we shall have an answer on that question.
I want to deal now with what I feel is one of the most serious weaknesses of the National Health Service in Scotland at present. That is the inadequate supply of maternity beds. This comes under Subhead A—"Advances to Regional Hospital Boards: Capital Account", and the figure is £394,000. The details we are given say that this is
Additional provision required for the acceleration of the programme of works.
What are these works? Do they cover a greater provision of beds for maternity hospitals? That is very important.
This morning I had a visitor who came to see me when I was in Committee upstairs. She was from Fort William, where she is a bailee. She is a member of the W.V.S. and yesterday she was entertained by the Queen at Buckingham Palace. I was telling her about the debate we were to have this evening, and I asked about the adequacy or inadequacy of the provision of maternity beds in her area. She told me that when it is decided by the doctor or the hospital authorities that an expectant mother ought to go to hospital to have her baby the woman has to travel to the nearest hospital, which is 65 miles away. Mallaig, in her district, is 100 miles away from the hospital. That is a very long distance for women to travel to find accommodation in a maternity hospital.
Recently a Report was published by a Committee appointed by the Scottish Health Services Council of the Department of Health for Scotland entitled "Maternity Services in Scotland." I want to quote from paragraph 81, on page 38, to show how serious is the position in Scotland. It reads:
We turned next to the distribution of the 70 per cent. institutional confinements.
This was 70 per cent. for Scotland as a whole.
A breakdown of the figures for 1957
—these were the latest figures which this high-powered Committee was able to get—
into local health authority areas showed variations from 96·4 per cent. to 50·4 per cent., with 21 areas over 80 per cent., 12 between 70 per cent. and 80 per cent., and 22 below 70 per cent., all but six of these last being among the 27 areas in the Western Region, which covers about half the population of Scotland.
This variation between 96·4 per cent. and 50·4 per cent. of the women having their babies in hospital is a very big variation. I would also point out that the Western Region covers the big industrial area of Scotland. It is very serious indeed that the worse provision should be found in the western area.
The Report continues:
On a regional basis the same discrepancy between the Western Region and the other four regions appears perhaps even more clearly. Only the Western Region, at 65·0 per cent., is below the national figure of 70 per cent. (Glasgow as low as 57·6 per cent. if only National Health Service accommodation is counted); the three smaller regions are all above 74 per cent. and the South-Eastern Region is 76·3 per cent.
That presents a very serious picture. The figures for the Western Region and particularly for Glasgow show that my hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann) has been absolutely right when she has been pressing the Secretary of State about the maternity hospital at Bellshill. The figures show that Lanarkshire, too, in the Western Region is not adequately served by the provision of maternity beds.
Paragraph 82 reads:
As to overcrowding and length of stay in hospital, the average length of stay in obstetric units in the Western Region is again markedly shorter than in the other Regions.
That must mean that where in other regions it is felt that women ought to

be kept in hospital for a certain period, in the Western Region they are not being kept in hospital sufficiently long. The Report continues:
and it is obvious that there is very little margin for the occasional emergencies, great or small, which are hound to rise in maternity units, from the closing of an entire unit because of infection, to the closing of one ward while it is painted.
That is a very serious matter. In the whole of this Western Region, covering half the population of Scotland, if any crisis arises, great or small, there is very little possibility of dealing adequately with it.
In Appendix VI we find the areas with a high hospital confinement rate and the areas with a local hospital confinement rate. Port Glasgow Burgh is the lowest with 52·4 per cent. of hospital confinements, Sutherland County is next with 53·2 per cent., Airdrie Burgh is next with 55·6 per cent., and the next lowest is Lanark County, which had over 6,500 births in 1956 and the percentage for which is only 56·3. For Dumbarton Burgh it was 57·2 per cent. and for Orkney County 58·1 per cent. All of these figures are well below the national average of 70 per cent., and if one reads the Report one is inclined to believe that even the national average of 70 per cent. is too low.
I will not quote too many figures but I will turn to Appendix VIII and to the figures of vital statistics for 1957. The still-birth rate per thousand live and stillbirths was 24·0 for the whole of Scotland. The figure for those who died when less than four weeks old was 20·0 out of every thousand and the figure for those who died under one year of age was another 29 out of every thousand. It is very difficult to obtain comparative figures—perhaps some of my hon. Friends have them—but we see that the figure was 29 for the whole of Scotland, and we know that in some areas it was very much worse. Indeed, all these figures are much worse in some areas. Nevertheless, we can compare the figure of 29 for the whole of Scotland with a figure of only 22 for London, which has a big, and a very mixed population. That shows a great difference.

Mrs. Jean Mann: London deplores its figure of 22. If a survey is made not only of London but of the Scandinavian countries


and of other European countries it will be found the Western Scotland area is the worst in Europe.

Miss Herbison: I know that it is worse than anywhere else in the British Isles, and that some of the other European countries, particularly the Scandinavian countries, return figures much better than some of the best figures in the British Isles.
How much of the saving of £400,000 in the hospital services, if any, was saved by not providing the maternity beds which were so desperately needed? If any of that saving were made by not providing these maternity beds, it is a great scandal, when we think of the mothers and the babies who lost their lives in Scotland last year.
Like the Minister, I want to pay a tribute to all in Scotland who are working in the National Health Service. I feel that they have done a wonderful job. I refer in our hospitals to the domestic staff, the nurses, the doctors, the consultants, and in our villages and our towns to the general practitioners, the district nurses and the midwives. They do a wonderful job.
It seems very clear from the speech of the Joint Under-Secretary of State and from the speeches of the English Ministers that they now accept the National Health Service. Although we feel that there are areas where savings can and ought to be made, particularly in the pharmaceutical service, in other services—and I cannot stress strongly enough in the maternity service and the provision of maternity beds—the Government ought to be providing far more. Is any coverage made in these Estimates for further provision?

8.11 p.m.

Sir James Henderson-Stewart: I should like to join the hon. Lady the Member for Lanarkshire, North (Miss Herbison) in congratulating my hon. Friend the Joint Under-Secretary of State upon the speech he delivered at short notice on a subject which is a little off his normal beat. He did it exceptionally well and I am happy that he did it in accordance with the traditions of the office.
The hon. Member for Lanarkshire, North has also given an example to the

Committee of an admirable and temperate speech. We are obviously dealing with a matter on which we are entitled to express our views without being tied to any party line. On this matter we should try to state the point of view that represents the human needs of our country and the hon. Lady did that with great skill, great knowledge and experience.
Listening to the two speeches which have been made, I came to the conclusion that probably the essence of what we are discussing tonight is the responsibility of the hospital boards. It is what the hospital boards are doing in their hopsitals that matters so much. In that connection, I was very interested to read the Report of the Acton Society Trust which we recently received. The Report is called "Creative Leadership in a State Service", meaning a State health service. It is a very interesting report on the various activities of the National Health Service.
The Report is addressed almost entirely to the English service. There are just a few words, but not any more, addressed to the Scottish service. Since there is a great deal of criticism in the Report, I should like very much to know from my hon. Friend whether the Report covers Scotland, whether, in the course of its examination, the Committee looked into Scottish affairs, and to what extent their criticisms apply to Scotland. It would be very interesting to know that.
The reason I press for that is that I want to know what measures my right hon. Friend the Secretary of State for Scotland is taking to give guidance to hospital boards on future policy. We have come to the end of roughly ten years of the National Health Service. As the hon. Lady said, it has done remarkable work. I agree with that. I agree with her, too, in paying tribute to the labours of the people concerned with the Service during those ten years. We have learned a great deal. There has been a tremendous development in spheres, many of which we had not thought of before.
Where do we go from here? Is it not fair to assume that the next ten years will be very different again? Things have been happening recently—the hon. Lady spoke about the maternity service; I could quote other examples—that are not to everybody's satisfaction, where some changes or developments are needed. At


this time, when we might say that we are consolidating or about to consolidate ten years' service, we should be thinking and Planning ahead.
I give another example of changes that have come about which nobody expected. The other day my right hon. Friend the Secretary of State for Scotland told us—I was very surprised to hear it—about the redundancy in the beds used for tuberculosis. He said that 1,000 beds had become redundant at the end of last year.Iremember—and I am sure that the hon. Lady remembers—many a debate in the past in the days when tuberculosis was a very serious thing and gave us cause for great anxiety. Fortunately, thanks to the efforts of the medical service and others, that period has apparently passed and we have reached the miraculous situation of having too many beds now. It is extraordinary.
Were we ready for the change? Were all the beds that were made redundant in that way used? Is there some other big need growing that we ought to know about? In other words, is the Scottish Health Department not only thinking forward, but advising hospital boards on the lines of their thought?
There is a need for assurance from my hon. Friend that the Secretary of State is both aware of the change in the nature of the problem and is taking proper steps to ensure that hospital boards are planning forward. We all know quite well that hospital boards and their staffs are mostly overwhelmed with work and worries. As the hon. Lady said, conditions change from area to area. A board of governors in a hospital is generally very busy on a large variety of small details; they are very important, but the tendency is to become overwhelmed with detail. The time has now come when we ought to be giving a clear directive to hospital boards to look ahead.

8.18 p.m

Mrs. Mary McAlister: I should like to return again to the question of maternity beds, a question which I have raised in the House more than once during the past year and which is rapidly becoming tragic in Glasgow.
The Medical Officer of Health for Glasgow stated quite emphatically in his 1957–58 Report that practically no progress had been made in this matter.
He repeated practically the same words to the Glasgow Herald as late as 12th February last. He further stated that Glasgow was at a considerable disadvantage in this respect, even in relation to other Scottish towns.
Figures have been given by my hon. Friend the Member for Lanarkshire, North (Miss Herbison). Fifty per cent. of Glasgow mothers can go to hospital to have their babies, as against 70 per cent. in Dundee and Edinburgh and approximately 90 per cent. in Aberdeen. I do not want to sound parochial, but I sometimes wonder whether the Minister realises the depth of the social problem which we have to face in the City of Glasgow. When the Second World War broke out, Scotland had the highest infantile mortality rate in the English-speaking world. With two exceptions, it was the highest of any country in Western Europe. Glasgow contributed in large measure to that very distressing record.
It is against that background, and in the face of housing conditions that, in some cases, can only be described as appalling, that the local authorities, medical and lay, as well as many tireless voluntary workers, have been striving to reduce the figures. Despite all their efforts, the figures remain substantially above the general level for the country as a whole.
We have heard many figures quoted tonight and I do not want to weary the Committee with many more, but I must point out that while there were 528 more births in Glasgow in 1957 than in 1956 there were 774 infant deaths in 1957; and that was the highest record since 1951. The 1958 figures have not yet been issued but I am told on good authority that they do not show a decrease. That is very serious indeed.
Is it any wonder that the people in Glasgow who are responsible for the maternity services feel frustrated? There are differences of opinion as to the desirability of all mothers having their babies in hospital—I even have some opinion on that myself—but could there be any difference of opinion as to where a mother should have her baby when she lives in a house which the medical officer of health admits he would condemn tomorrow if he had anywhere to put the tenants?
A recent Report of the Scottish Health Services Council on Maternity Services in


Scotland—and my hon. Friend the Member for Greenock (Dr. Dickson Mahon) reminds me that I gave evidence, though I had forgotten—states that it is thought very undesirable that mothers should leave hospital before the end of ten days. It is undesirable, primarily, for two reasons: first, because the mother is not strong enough to take up the domestic reins as she should; and, secondly, because of the difficulty in getting domiciliary midwives.
The Report states that it is quite common for a mother to leave hospital after seven or eight days, or even fewer. A great deal of inconvenience is then caused to those responsible for taking care of her, but how much more inconvenience is caused if she is in a house that is due to be condemned, or is even actually condemned? I could tell quite a number of harrowing stories about the conditions in which some young mothers are living in my constituency, but I have never used that type of propaganda and I do not propose to start tonight. I will repeat only one, and then only because there is a slight touch of humour in it.
A young mother complained to me about rats in the house. She was a very decent person, who kept a very clean house, and she did not want to appear to be too much of a grumbler. She said, "I am not saying that they went near the weans, as they did to the woman upstairs, but they nearly bit the e'en out of my kitten." That is a true story. I leave it to the consciences of right hon. and hon. Members opposite whether they consider such a domicile a suitable place in which to have a baby. I implore the Joint Under-Secretary to press on his right hon. Friend the need to do something about the provision of maternity beds in Scotland.

8.26 p.m.

Mr. Douglas L. S. Nairn: I should like to support, with all the feeling I have, the speeches of the hon. Ladies the Members for Lanarkshire, North (Miss Herbison) and Glasgow, Kelvingrove (Mrs. McAlister). I will not follow them in a discussion of the maternity service, but my view is that it is the one thing that is not yet adequately catered for in the National Health Service.
I join my hon. Friend the Member for Fife, East (Sir J. Henderson-Stewart) in

saying how well the first ten years of the Service have gone. Broadly speaking, we can say that at the end of ten years the medical and hospital facilities are adequate to look after all who are ill and for as long as they remain ill. We have a service under which every child who is born able to grow up healthy is almost a guarantee that it will grow into a healthy adult.
That story is satisfactory as far as it goes, but we have three distinct problems to face—the prevention of sickness and disease, the rehabilitation of patients when released from hospital, and the care of the old so that, when we do go out, we do not have to go out after a long period of suffering from the ailments of senescence. Prevention of sickness and disease can be helped to a large extent by propaganda, and we see under Subhead K10 that
Adtional provision required mainly to meet increased expenditure on health propaganda" is £8,000.
It is true that our hospitals, technical institutes of all sorts—and, particularly, outstanding individuals—have produced all sorts of cures for those struck down by disease. It is equally true, and it has been emphasised over and over again during the last few years, that of all European countries we still have far and away the largest number of serious chest complaints—and, I believe, that the same is true of any country where statistics are kept.
Speaking the other day in Edinburgh, the Minister of State said that in the 17 main cities of Scotland, deaths were twice as high between mid-January and mid-February, 1959, as they were in the same period of last year. There were 468 deaths in Glasgow in 1959 as against 197 in 1958. I am no expert on these things but it is quite clear to me that that is not due to the climate of Scotland. It can be due only to one thing, and that is the pollution of our atmosphere. I do not know whether my right hon. Friend the Secretary of State has seen a pamphlet sent out, not by the Department of Health, but by the Ministry of Housing and Local Government which says "Smoke is Your Enemy." I am quite sure that the more we can do to make people realise what a terrible menace smoke is—I am speaking of smoke in the atmosphere, not tobacco smoking—the


more quickly shall we reduce the very high proportion of chest complaints.
No one motoring towards Glasgow can fail to notice, even on a sunny day, that one suddenly sees a black cloud in front of one and then arrives in a city Which might be under the ground altogether, while all round about there is sunshine. We have the Clean Air Act. The most important thing today is for the Scottish Office to ensure that local authorities are made to make full use of it. People in their homes, also, must be made to realise the added dangers which they put into the atmosphere unless they install new and modern forms of heating appliances.
Turning to the rehabilitation of patients after discharge from hospital, I want to ask my hon. Friend whether any steps have been taken or are being taken to implement that part of the Piercy Report which recommended the setting up of resettlement clinics to help people who are left with some disability after they come out of hospital. If a person cannot find a job after he comes out of hospital, and if he still has some disability, deterioration sets in fairly rapidly. I hope that we shall have news of something being done to establish such clinics.
I should be out of order if I went on to discuss the position of old people, but I hope that it will be appreciated more and more that if people are not to suffer from the ills of senescence in later life they must be kept at work, or they must be given opportunities to take up hobbies or be encouraged to take up voluntary work. We all look forward to the time when people can live happily and, so far as they are able, actively, until they die and not have to suffer a long period of ill-health or neurosis.

8.31 p.m.

Mrs. Jean Mann: I wish briefly to comment upon certain items in the Estimates and make some suggestions. I shall not make a long speech, because I want to go to have something to eat as soon as possible. I raised last year a great many of the points which have been raised about maternity and midwifery services in Scotland, when I spoke on the Estimates. The services could be streamlined. Where there is difficulty in providing enough beds, care ought to be exercised so that

the beds which are available go to the right people.
There are many women, whose housing conditions are perfect, who have a second or third safe confinement in hospital. I never had a confinement in hospital, and I have had six. To me, the birth of a child was a very happy thing. It took place in my own home. My husband loved the idea of my being at home, because it gave him a grand excuse for entertaining all his friends and "wetting the baby's head". When I came to my third, fourth, fifth and sixth confinements, my children were exceedingly glad that their mother was not packing up and leaving them to go away somewhere—they never could understand exactly where. I was always at home.
There must be many women who could well have their confinements at home. Indeed, it is a very joyous event, the most joyous event in a young couple's life. Having one's baby in hospital, with doctors and nurses in attendance, good people though they are, and leaving one's children behind at home, is a horrible idea to most mothers.
We know that it is always wise for the first confinement to take place in hospital. There are specialists who deplore the idea of having the fourth, fifth or later confinements at home, and it is thought that mothers entering von these later confinements should go to hospital. Is it possible to devise a system whereby priority would be given to women having their first confinement or their fourth or further confinement, and to women whose home circumstances are such that it is not advisable for the baby to born there?
There is this further difficulty. Although we have had a free home midwifery service in Scotland for almost twenty-two years, we have never had agreement on how we should operate it. I was in Glasgow at that time and our doctor would not allow a Glasgow doctor to undertake a confinement unless he had had at least seven years' experience of bringing babies into the world. England has a very wise system. Here no doctor is allowed to undertake midwifery unless he has served a six months' post-graduate course. I think that this is halfway towards the recognised diploma of the Royal College of Obstetricians and Gym-ecologists. If a doctor has this qualification, he then knows how to meet complications which


may arise in the course of a confinement. Some of the things which I have mentioned have been recommended in the Report by the Maternity Services Review Committee in Scotland. I hope that they will be carried out.
I have a complaint to make about the ambulance service. In this respect, some areas are over-serviced. There are patients who travel in an ambulance when they could quite well walk. Some patients insist on being driven home when they could quite well walk. I know that some specialists have told patients to walk and have received the reply that the patient's doctor insists on an ambulance, and if he dared to refuse the patient would threaten to take his medical cards to another doctor. There is far too much bullying of doctors by patients who threaten to take their medical cards to another doctor who, for the sake of getting a few extra fees, will take on anybody.
There have been complaints throughout my constituency of an ambulance arriving with only one man. How is it possible for one man to manipulate an invalid on to a stretcher? In such cases, extra help has to be sought. I have had complaints from men who have had to take time off from work because they knew that an ambulance with only one man was coming for their wives. We should have value for the money which we are spending. People should use the Health Service and not abuse it. They should walk if they are able to do so and should allow the ambulance to be used by others who most need it and for whom it is absolutely essential.
I agree with what has been said about the ten-year vision of the future. There should be a bit of automation in the Health Service. Let me consider, first, the rate of growth in the care of mothers and young children by home nursing and domestic help. There is a great appreciation of the home helps and many complaints that we have not enough of them. Why do we always insist that home helps should be women? Has nobody heard of men cooks, batmen, or retired male nurses?
Why not recruit men as domestic helps? I know quite a lot of crotchety old bachelors who insist on going into hospital rather than "have a woman mucking around my apartment", but they would not mind if it were a man—say, an

ex-Army man or one who had been a male nurse. I suggest that we turn our attention to the fact that there are men who are good cooks, men who can tidy up a kitchen, make beds and see another man comfortable, and who can give the kind of domestic help that is given mostly by women.
I think that the home nursing, domestic help and care of mothers and young children services could be streamlined. I know many lady doctors who, on an afternoon, have let it be known far and wide that that is the afternoon when they run their clinic for women and children. I know that these are very popular clinics. Again, it is an idea borrowed from England. The mothers come along with their babies and it is probably their own lady doctor to whom they are coming.
If we operated the same geriatric treatment as is given in some of the English hospitals, particularly in London, where elderly people are taken inside for a period—perhaps it is six weeks in hospital followed by six weeks at home—we might put these old people back on their feet. We might manage to eliminate a good deal of the nursing and also of the home help service. If we streamlined, we could pare down a good deal of the inconveniences and the expense of one or two of these services.
I should like to pay a compliment to the Department and particularly to the Joint Under-Secretary of State, the hon. Member for Craigton (Mr. J. N. Browne), for the extremely good work he has done in Scotland in the prevention of illness and the prevention of home accidents, which account for more deaths than polio or any other infectious disease. The memorandum introduced by the hon. Gentleman, showing local authorities how they could get the money for setting up committees, has been of great service and gave a lead to England, because we managed to get the English Minister to follow his example.
Now, the hon. Gentleman's "Designing for Safety" booklet, which is going out to every local authority in Scotland, is one of the best things that we have had in Britain for preventing home accidents. Again, the English Minister has promised at Question Time that he will follow Scotland's example and distribute this book to all the English authorities.
Finally, the Joint Under-Secretary has introduced a grant for Scotland that has never been given before by any party. 142 is giving for Scotland as much as has been given for the whole United Kingdom in the way of accident prevention. I am pleased to pay this tribute—

The Temporary Chairman (Major H. Legge-Bourke): The hon. Lady must not pursue this topic any further. It is not carried on this Vote.

Mrs. Mann: Thank you, Major Legge-Bourke. That is all I had to say.

8.45 p.m.

Mr. George Lawson: I should like to turn again to this question of the additional £17,000 provided for the purchase of ambulances and ambulance equipment.
When I put a Question to the Secretary of State for Scotland on 23rd February, asking—
which English and which Scottish firms were invited to tender for contracts for new ambulance service vehicles"—
I expected information about the firms which had been asked to tender. I did not expect that I should be given a reason for there being no invitation to tender at all to the Scottish firms. Indeed, I was rather surprised to find such a strong statement—a damning statement, I would say—made in answer to my Question. My hon. Friend the Member for Lanarkshire, North (Miss Herbison) has already read the statement, but I feel that it would do no harm to repeat it. The Secretary of State said:
The Joint Central Committee for the Scottish Ambulance Service advised me that it was urgently necessary to provide additional vehicles to avoid a breakdown of the Service during the winter."—[OFFICTAL REPORT, 23rd February, 1959; Vol. 600, c. 119.]
Because of the great urgency, there was no time at all to invite the Scottish firm which has for years been supplying these vehicles to tender.
It is rather astonishing that we should be told that the Scottish ambulance service was apparently on the verge of breakdown during the winter—a damning statement indeed—and in order to try to understand how this came to be, I have looked back over the Estimates since 1951–52. I find that there appears to have been a more or less regular Estimate for this kind of work—the provi-

Sion of ambulances and the equipment for the vehicles—and that a regular £70.000 was provided each year.
In fact, in 1952–53 the Estimate was £85,000, but—and it is rather significant, and may throw some light on why this position was allowed to arise—I notice that whereas the Estimate was £85,000, apparently, in that year only £35,000 was spent. That was a year in which there were efforts to reduce expenditure, but the result of that reduction in expenditure in 1952–53 was to push up the expenditure in the following year to £140,000. Since that time—and this seems, to my mind, to be the beginning of the explanation of the present position—in 1956–57, the expenditure was reduced from £70.000 to £50,000, and in 1957–58 the estimated expenditure was down to £8,000.
From what I can judge, only £5,000 was spent in that year. It seems to me that what 'has happened here is that there has been an almost complete cessation of the ordering of ambulances. That seems to be what has happened over the past few years. If we take it that in 1957–58 only £5,000 was spent on ambulances and equipment, as compared with what seems to have been a regular figure of £70,000, it would appear that nothing at all was spent on the actual purchase of vehicles in that year.
The Estimate for 1958–59 was again very much down on what seems to have been the normal Estimate. It was, in fact, only £39,000. It is the supplementation of that £39,000 by an additional £17.000 with which we are concerned tonight. It seems to me, looking at this matter as I think we are bound to look at it, that there has been an effort so to reduce expenditure on the purchase of ambulances and ambulance equipment that we have been pushed into a position in which in this winter the condition of the fleet was such that, to avoid a breakdown, there had to be this hurried, or what seems to have been a very hurried, ordering of these vehicles. It is very serious and most reprehensible that such an important part of the Service should have been allowed to run down over two years in this way.
There are one or two related questions which I should also like to put to the Joint Under-Secretary of State for Scotland. I appreciate that this is not his


department but I know that he will make an effort to reply. If I am wrong, I am sure that the hon. Gentleman will correct me, but I was lead to believe that the placing of these orders in 1958, in respect of which the supplementation of £17,000 is partly to be paid, was not by the Scottish Office but by the Ministry of Supply.
I understand that a Ministry of Supply official visited Scotland, inspected the ambulance fleet and apparently made models or copies of certain Scottish ambulance vehicles. The Scottish ambulance vehicle differs from the English because in Scotland there are high tenement buildings with spiral stairways, with the result that the type of stretcher used has to be such as can be much more easily manoeuvred than the type used in England. I understand that it follows that because of the shape of the stretcher the shape of the typical Scottish ambulance is different from that of the English ambulance.
I am told that the Ministry of Supply official who made drawings or prepared models of the Scottish ambulance took his drawings to an English firm which provided the ambulances in 1958. We are told that the position was so urgent that there was no time to do otherwise than ask an English firm to supply these ambulances. That is absolutely disputed by the Scottish firms which in the past have provided these ambulances. They say that they could have met the demand for the main bodies more quickly than it was in fact met.
Is it true that the orders for these ambulances were not placed by the Scottish Office? I should have thought that the Scottish Office normally placed these orders. It is said that the orders were placed by the Ministry of Supply official with an English firm or firms without the Scottish firms being asked to tender. That is certainly true.
I do not wish to appear nationalistic and I do not argue that everything used in Scotland should be made in Scotland. Far from it, for Scotland exports as well as imports. But in a matter of this kind, when there has been a regular meeting of Scottish needs on the basis of what is a small industry, it is very unfortunate if a Ministry of Supply official apparently has the power to bypass the Scottish

Office and place orders almost on the basis of his own judgment in this way. This is a bad thing. I hope that the Joint Under-Secretary will tell me if I am not correct, but if the facts are as I have described them, I hope he will assure me that this will not happen in the future.
We are being asked to grant an additional £8,000 for the provision of the midwifery service, mainly to meet the cost of additional staff. Recently I received a deputation of midwives from my constituency. I had not known that they were as much concerned as they are. I thought midwives seemed to think more of service than of themselves and were happy in their job. Apparently, however, there is a strong feeling of grievance among midwives, certainly among those who came to see me.
As a result of their visit I read the report of the Adjournment debate on 23rd January which was initiated by my hon. Friend the Member for Southampton, Itchen (Dr. King). I was surprised to learn that, although there were more than enough women coming forward for training as midwives, and although there were more than enough who qualified, the service could not grow because of the numbers who left it. Apparently this was due to the conditions under which they work. For example, the midwife is highly qualified and her job must be one of the most vital in this country, since she is engaged in delivering children and looking after the mothers. I was surprised to find that the pay ranges from £10 a week to a maximum of £12 4s., which is below the national average.
I know that it is not in order here to argue about increases in wages, but I should like to know whether the conditions described by my hon. Friend the Member for Itchen, when speaking of midwives in England and Wales, also exist in Scotland. If they do, how far does the Joint Under-Secretary think that £8,000 will go towards remedying the deficiencies?

Dr. J. Dickson Mahon: Dr. J. Dickson Mahon (Greenock) rose—

8.59 p.m.

Mr. N. Macpherson: I apologise to the hon. Gentleman the Member for


Greenock (Dr. Dickson Mabon) for rising, but I promised to sit down at a quarter past nine to give time for a further debate.

Dr. Mahon: On a point of order, Sir Charles. Is it possible for me to protest at the fact that I have attended the whole of this debate and that the Minister has now been called?

The Chairman: That is not a point of order. If a member of the Front Bench rises, I call him. It is not in my hands. There is still half an hour to go and I hope that the Minister will not speak for half an hour.

Mr. Thomas Fraser: The Minister has said that he has promised to sit down at a quarter-past nine. Is there any reason why he should not finish at half-past nine?

Mr. Macpherson: There is another Estimate to come after this one and it is expected that there will be a short time in which to present that Estimate at the end. I apologise to the hon. Member for Greenock, but I hope that he will allow me to continue my speech.

Dr. Mahon: No. I think that it is a very grave discourtesy, considering all the time I have been here.

Mr. Macpherson: I regret that, but I am afraid that time is against us. It is unfortunate that we should have ended on this particular note, because this has been a very even tempered and extremely useful debate.
I should like to thank all those who have spoken for the way in which they have approached this debate and, in particular, for the tributes that have been paid by the hon. Lady the Member for Coatbridge and Airdrie (Mrs. Mann) and others to my hon. Friend the Member for Craigton (Mr. J. N. Browne) for his work for the Health Service.
The hon. Lady the Member for Lanarkshire, North (Miss Herbison) dealt, first, with the pharmaceutical service and I should like to deal with her question. She asked what were the costs of the services in Scotland. The average cost per prescription in Scotland is 7s. 6½d. This is 1s. 1d. higher than the average cost per prescription for England and Wales. Without going into details, I would say that, despite the high average cost per

prescription, the cost of the pharmaceutical service in Scotland per patient on doctor's lists is almost exactly the same as in England and Wales.
The reason is that there are more pharmacists in Scotland in proportion to the population. There is one for every 3.000 persons in Scotland compared with one for every 3,400 persons in England and Wales and proportionately fewer prescriptions, 3·9 per head annually compared with 4·5 in England and Wales.
Each pharmacy has to employ a qualified dispenser and assistants, as does an English pharmacy, and the cost has to he covered by the fees for proportionately fewer prescriptions. That means there is a difference here, as well as the difference in prescribing practice in Scotland, as compared with England and Wales. The hon. Lady also asked about the rota system. If I may I shall ask my lion. Friend to write to her on that point.
On the ambulance service, a good deal was said by the hon. Member for Mother-well (Mr. Lawson) and the hon. Lady for Lanarkshire, North. I should like to say to the hon. Lady the Member for Lanarkshire, North that any need for an urgent order was not due to any holding back by the Government owing to economic difficulties. I think that the hon. Member for Mother-well has already made that case tonight. I should only like to add that the points which the hon. Member for Mother-well have made will be very carefully looked into. As he knows, an answer has been given to him on this point and on the special procedure for single tender which has been touched upon by him. I do not wish to go into further details. I can only assure him that the points which have been made will be carefully looked into.

Miss Herbison: The Minister suggested that my hon. Friend had made the case that it was not because of economy. I listened carefully to what my hon. Friend said about what has been spent over the years. Whether one calls it economy, or not spending the money, it still means that we are in this position because the money was not spent.

Mr. Macpherson: I understood the hon. Member for Lanarkshire, North to be asking whether the need for this order being urgent arose out of the economies


imposed by the Government this year. I think that she was attaching it to the figure of £400,000. I am saying that it was not related to that. The fact that there is £39,000 included in the Estimate this year which, as the hon. Gentleman has said, is a good deal more than the previous year, indicates that any economy was in the previous year and not in this year.

Mr. Lawson: The hon. Gentleman is misrepresenting me, although he may not be doing so deliberately. If, in fact, there was £70,000 expenditure which fell to £5,000 and then, in the following year, the figure was only £39,000, that would suggest that the problem facing us now is due to that heavy reduction in expenditure.

Mr. Macpherson: The hon. Gentleman will realise that the ambulance service had to be built up to start with. No doubt an estimate was made of the time the vehicles would run and some vehicles did not last that long, hence the need for the urgent order. That is what I suppose to be the case, but I assure the hon. Gentleman that what he has said will be carefully looked at.
The hon. Lady asked about midwifery staffing and whether there was an adequate service in every part of Scotland today. She may like to know that, on average, there are about 48 confinements per midwife per year and the Working Party on Midwives which reported in 1949 regarded a case load of 55 a year as reasonable. The case load for midwives in hospitals has been maintained at 35 per midwife per year. It was at that figure in 1950 and the figure was still the same in 1957.
The main point made by the hon. Lady related to the question of maternity beds. It is accepted by all concerned that additional maternity beds are required in Glasgow which has the lowest proportion of institutional confinements in the four cities. The figure which I have does not quite accord with that of the hon. Lady. It is 62·4 per cent. compared with 70·2 per cent. for Scotland, but, in any case, we are agreed that it is low.
On the basis recommended by the Maternity Services Review Committee—the Montgomery Committee—about 850 maternity and ante-natal beds would be needed for Glasgow. At present, there are 693 beds. Work is expected to begin

in the spring of next year on the 112-bed Yorkhill Maternity Hospital, the plans for which are now in final form. Twenty additional beds will shortly be available at the maternity unit at Robroyston Hospital through the conversion of existing accommodation there. Plans for a 53-bed unit at the Belvidere Hospital have recently been submitted by the regional board to the Department of Health, and are receiving urgent consideration.
In Lanarkshire, work is in progress on a new 120-bed maternity unit at Bellshill which it is expected to complete in 1961. Thirty additional beds have already been brought into use as a temporary measure in accommodation vacated by nurses, and 14 other additional beds will come into use shortly at Hamilton and Lanark. In Renfrewshire, Thornhill Maternity Hospital has recently been extended to replace the out-moded maternity unit at Barshaw, which is now being converted for geriatrics. In Dunbartonshire and Dumfries, also, there are improvements under way.
We appreciated the speech of the hon. Lady the Member for Glasgow, Kelvin-grove (Mrs. McAlister). We are attaching the greatest importance to this in Glasgow. It could be said that the regional hospital board puts the first priority on maternity hospitals and the care of old age.

Mrs. McAlister: Can the hon. Gentleman tell us when the work at Yorkhill will be completed?

Mr. Macpherson: I cannot tell the hon. Lady that, because I have not the information available.

Miss Herbison: The Minister is suggesting that work at Yorkhill will begin in the spring of 1960, but he also said that the plans were almost ready. If the Scottish Office is seized of the importance of providing better maternity accommodation in Glasgow, surely the summer months of this year could be utilised to begin the work rather than that it should wait until the spring of next year.

Mr. Macpherson: I am sure that my right hon. Friend will take note of what the hon. Lady has said. I cannot tell her whether it is possible or not.
On infant mortality, I have not the latest figures for Glasgow, but I have


stated what the hospital authorities are doing to increase the number of maternity and antenatal hospitals and so to provide the better service we all desire. In Scotland as a whole the Registrar-General's provisional figure for 1958 shows that infant mortality was the lowest yet recorded. For every 1,000 live births there were 28 deaths of infants under one year, compared with 29 in 1957 and 47·3 in 1946–50. My right hon. Friend is concerned to make sure that that figure should be lowered further as fast as possible. I can give that assurance to the hon. Lady.
My hon. Friend the Member for Fife, East (Sir J. Henderson-Stewart) asked about the recent Acton Society Trust Report, and whether it covered Scotland. While much of what is said in this Report, and in previous Acton Society Trust Reports, has been written primarily with reference to conditions in England and Wales, the Trust has, of course, covered Scotland in its inquiries. My right hon. Friend and his Department have taken careful note of the views of the Trust.
On the question of leadership, which is perhaps the Trusts' main criticism, I suggest it is necessary to strike a balance. The hospital service in 1948 was a series of disconnected units when it was taken over. It must be allowed to grow gradually into one coherent organisation. It relies very largely on voluntary effort in the hospital boards and has derived great benefit from the efforts of those individuals. All this would be lost by anything resembling regimentation. My right hon. Friend believes, as I think his predecessors have done, that in some respects it is possible from St. Andrew's House to guide and to lead, but that it would be quite wrong to command and direct, save in the last resort. The military parallel drawn by the Acton Society does not seem to me to be a good one.
Perhaps I might mention one or two examples of the ways in which we have tried to do some of the things which the Acton Society has in mind. We have just sent to the hospital authorities a memorandum on some of the major questions of policy and organisation to which my right hon. Friend thinks they may wish to give more attention than has been possible in the difficult conditions of the first years of the Service. We have begun a series of

discussions round the table with each regional board in turn, about the direction in which it should seek to develop the Service over the next few years. I can assure the Committee that there is no question of not looking forward and planning ahead.
Within the Department we have set up special machinery to study the trends of medicine, morbidity, and so on, to try to assess their impact on the hospital service. We are also strengthening the technical staff to cope with the architectural and other problems arising from new hospital building. On the building programme itself, we have provisionally agreed with the hospital authorities a list of the major projects which we and they would like to put in hand up to 1965, subject, of course, to resources being available when the time comes and to later adjustment for changing conditions. We had also begun to study with them farther distant projects which will take us up to 1970.
Perhaps I may turn to more immediate problems. We arranged a highly successful conference last year to examine, with the hospital authorities, the application of work study to the hospital service. The Department is setting up a special branch to deal with this and allied subjects, and the officer who is to take immediate charge of it is at present on detached duty studying the subject further with I.C.I. These are examples of what we are doing. While we welcome consiructive criticism of the kind made by the Society, and, indeed, of the kind that has been made in the Committee tonight. I suggest that my right hon. Friend and the Department are not quite so lacking in leadership as the Society's Report would suggest.
Although I have not been able to deal with all the points raised, I shall take note of the points made by the hon. Lady the Member for Coatbridge and Airdrie, with all her usual rugged vigour, and the point made by my hon. Friend the Member for Central Ayrshire (Mr. Nairn). What I have said will, I hope, be sufficient to show that these Supplementary Estimates represent a step forward as well as covering the higher cost of salaries, and so forth; and, as my right hon. Friend said before, they are in no way an indication of extravagance.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £2,376,500, be granted to Her Majesty to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the provision of a comprehensive health service for Scotland and other services connected therewith, including medical services for pensioners, &amp;c., disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, certain training arrangements, the purchase of appliances, equipment, stores, &amp;c., necessary for the services, certain expenses in connection with civil defence, and sundry other services.

CLASS VIII

Vote 1. Ministry of Agriculture, Fisheries and Food

Motion, made, and Question proposed,
That a Supplementary sum, not exceeding £290,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March. 1959, for the salaries and expenses of the Ministry of Agriculture, Fisheries and Food; of the Agricultural Land Commission; of the Royal Botanic Gardens, Kew; and of the White Fish Authority and the Scottish Committee thereof.

9.16 p.m.

The Minister of Agriculture, Fisheries and Food (Mr. John Hare): The Supplementary Estimate for Vote I amounts to £290,000, of which all is needed for salaries. We need £150,000 to cover the recently announced 3½ per cent. increase in the pay of non-industrial staff. We have not been able to cut down the numbers of staff as quickly as we expected, largely because we have had more work to do, although in the last twelve months our staff has been reduced by 400. This accounts for an extra £208,500.
Against those additions, I can show a saving of £75,000 on fees to local veterinary inspectors for work under the Diseases of Animals Act, 1950. That is mainly because the original Estimate provided for fees for the herds we had freely tuberculin tested was larger. After taking into account the additional salary increases for those employed at Kew Gardens, the net increase is £290,000.

9.17 p.m.

Mr. Frederick Peart: I wish to ask one or two questions on this Supplementary Estimate and to add one or two questions affecting other Votes. On the question of savings on work done by local veterinary inspectors, I should have thought the answer was—

The Chairman (Sir Charles Mac-Andrew): If the hon. Member wants to speak on other Votes, they will have to be called first.

Mr. Peart: I should have thought that these were not only high, but that where L.V.I.s have done particular work in an area and where the work has been successful a large sum of money must have been saved. An increase of expenditure under Subhead A1 would represent a successful operation by local veterinary inspectors. I hope that if there is a decrease in fees in a particular area that represents a saving to the nation—in other words, that we are having healthier herds—and if any more has to be spent on the L.V.I.s it has to do merely with routine rechecking. If fees have been high that shows that the policy of attestation and clearing of areas has been successful.
There is another point which I wish to raise, if I may deal with it now—

The Chairman: It is on another Vote?

Mr. Peart: Yes, Sir Charles.

The Chairman: We had better get rid of this Vote first.

Mr. Hare: I suggest that it would be most helpful to the hon. Member, if at this stage, I say that I would like to take note of the points he raises and I shall certainly inform him of my comments one way or another, but the less I say now the more helpful it will be to the hon. Member.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £290,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the salaries and expenses of the Ministry of Agriculture, Fisheries and Food; of the Agricultural Land Commission; of the Royal Botanic Gardens, Kew; and of the White Fish Authority and the Scottish Committee thereof.

CLASS VIII

Vote 2. Agricultural and Food Grants and Subsidies

Motion made, and Question proposed,
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, by the Ministry of Agriculture, Fisheries and Food for grants and subsidies


to farmers and others for the encouragement of food production and the improvement of agriculture; for payments and services in implementation of agricultural price guarantees; and for certain other services including a payment to the Exchequer of Northern Ireland.

9.20 p.m.

Mr. Frederick Peart: May I ask for an explanation of the calf subsidy and the additional number of calves? While I welcome it, may I be told the reasons for the increase in the calf subsidy?
My next question concerns cereals. I understand that the increased figure here is due to an all-round fall in market prices; but to what extent have the buyers affected prices, what has been the influence of the millers on prices and what has been the Treasury's r·le? If there has been a fall in cereal prices, why has there been no fall in the price of bread? What does the Minister mean by "variation of quantities"?
Again, on Subhead B5, has the price of imported wool fallen? How has it affected prices for home-produced wool?

9.21 p.m.

The Minister of Agriculture, Fisheries and Food (Mr. John Hare): I will respond briefly to the series of important questions which the hon. Member has flung at me, but I should like to deal with them in detail later. There was an unexpectedly large increase in the retention of calves on the farms with the heavy demand for beef stores. The Supplementary Estimate takes into account the increased number of calves which are expected to qualify for subsidy. This is something about which we can feel well pleased, because it shows that we are building up our supplies of beef in this country.
I want to help the hon. Member, and I think that it would be better for me to answer the other questions in detail at a later stage or privately rather than to continue my speech now.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, by the Ministry of Agriculture, Fisheries and Food for grants and subsidies to farmers and others for the encouragement of food production and the improvement of

agriculture; for payments and services in implementation of agricultural price guarantees; and for certain other services including a payment to the Exchequer of Northern Ireland.

Vote 3. Agricultural and Food Services

Motion made and Question proposed
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, by the Ministry of Agriculture, Fisheries and Food, for grants, grants in aid and expenses in connection with agricultural and food services; including land drainage and rehabilitation of land damaged by flood and tempest; purchase, development and management of land, including land settlement and provision of smallholdings; services in connection with livestock, and compensation for slaughter of diseased animals; provision and operation of machinery; training and supplementary labour schemes; control of pests; education, research and advisory services; marketing; agricultural credits; certain trading services; subscriptions to international organisations; and sundry other services including certain expenses in connection with civil defence.

9.22 p.m.

Mr. Frederick Peart: I thank the Minister for his courtesy in offering to give me further details later in answer to my questions on the previous Motion.
The land drainage grants are very important, especially in view of the heavy flooding last year. In many parts of the country, I understand, there is still a serious problem of heavy silting in our ditches and our main rivers, particularly in such areas as Anglesey, where it has given rise to liver fluke disease, a problem which affects the sheep flocks. I should like the Minister to be liberal in his interpretation of land drainage grants, because much of the main capital work done just after the war by prisoner-of-war and ex-prisoner-of-war labour has not been satisfactory. I hope that he will look at this again.
Under Subhead D 6, "Pig Progeny Testing Stations—Capital expenditure," does the Minister intend to encourage the creation of another pig progeny testing station? Five are in existence, four in England and Wales and one in Scotland. Has he been in touch with the National Pig Progeny Testing Board and the Pig Industry Development Authority? Has there been any delay in the work? Why this Vote?
My last question concerns the grants for local authorities in respect of rodent control. Since the county executive committees no longer have direct responsibility and the original administration has been wound up, and since the farming community now has to rely on private contractors, I should like to know whether there have been any complaints from the farming community on the efficiency of the existing scheme or about increased costs. Are the present arrangements for rodent control satisfactory? Why is there an extra grant to local authorities? I know that they still have a statutory obligation. Is the increased Estimate due to increased costs for the service which has been handed over to private contractors? Rodent control is a vital service not only to the farmer but also to the community.

9.24 p.m.

The Minister of Agriculture, Fisheries and Food (Mr. John Hare): The hon. Member has put a series of questions in rapid, streamlined form to which I should like to give serious consideration. I will give him detailed answers at an early date. For reasons which he knows, it is impossible for me to attempt at the moment to give detailed explanations of the many questions which he has put to me.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, by the Ministry of Agriculture, Fisheries and Food, for grants, grants in aid and expenses in connection with agricultural and food services; including land drainage and rehabilitation of land damaged by flood and tempest; purchase, development and management of land, including land settlement and provision of smallholdings; services in connection with livestock, and compensation for slaughter of diseased animals; provision and operation of machinery; training and supplementary labour schemes; control of pests; education, research and advisory services; marketing; agricultural credits; certain trading services; subscriptions to international organisations; and sundry other services including certain expenses in connection with civil defence.

Vote 11. Department of Agriculture for Scotland

Motion made, and Question proposed,
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge will will come in course of payment

during the year ending on the 31st day of March, 1959, for the salaries and expenses of the Department of Agriculture for Scotland and the Crofters Commission; for grants and subsidies to farmers and others for the encouragement of food production and the improvement of agriculture; for certain payments in implementation of agricultural price guarantees; and for grants, grants in aid and expenses in connection with services to agriculture; including land drainage and flood services; purchase, improvement and management of land; land settlement; public works in the congested districts and roads in other livestock rearing areas; services in connection with livestock and compensation for slaughter of diseased animals; provision and operation of machinery; training and labour schemes; control of pests; agricultural education, research and advisory services; marketing; and agricultural credits.

The Joint Under-Secretary of State for Scotland (Lord John Hope): Perhaps I can take the headings under this Vote as they come and explain to the Committee the reasons for them.
A.4—Crofters Commission. The increase is necessitated by a greater staff complement authorised after a visit of a Treasury Staff Inspector in June, 1958, and by a recent award of 3½ per cent. increase on certain salary scales as from 1st December, 1958.
B.9—Calf Subsidy. The original estimate was based on the assumption that 300,000 calves would qualify for subsidy during the financial year 1958–59. From the outcome of the scheme to date and the 1958 June census figures, it is now estimated that the total number of calves qualifying for subsidy may be 327,000, which would commit us to expenditure of around £2,645.000. The rates of subsidy are £8.l0s and £7.l0s for steer and heifer calves respectively.
B.10—Subsidy payments in respect of hill sheep and hill cattle. The additional sum required is £65,000. One hundred pounds of the above Estimate is a token sum to meet remanet payments in respect of hill sheep subsidy from earlier years. The remainder of the Estimate is for hill cattle, the subsidy being £10 per head. From the information now available to us, it is expected that the number of hill cattle qualifying for subsidy in 1958–59 will be 6,500 more than originally estimated.
C.1—Cereals. The additional sum required is £400,000. The additional sum is required to cover—

It being half-past Nine o'clock, The CHAIRMAN proceeded, pursuant to Standing Order No. 16 (Business of Supply), to pot the Question necessary to dispose of the Vote under consideration.

Question put and agreed to.

Resolved,
That a Supplementary sum, not exceeding £10, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for the salaries and expenses of the Department of Agriculture for Scotland and the Crofters Commission; for grants and subsidies to farmers and others for the encouragement of food production and the improvement of agriculture; for certain payments in implementation of agricultural price guarantees; and for grants, grants in aid and expenses in connection with services to agriculture; including land drainage and flood services; purchase, improvement and management of land; land settlement; public works in the congested districts and roads in other livestock rearing areas; services in connection with livestock and compensation for slaughter of diseased animals; provision and operation of machinery; training and labour schemes; control of pests; agricultural education, research and advisory services; marketing; and agricultural credits.

The CHAIRMAN then proceeded forthwith to put severally the Questions, That the total amounts of all outstanding Estimates supplementary to those of the current financial year as have been presented seven clear days, and of all outstanding Excess Votes, be granted for the Services defined in those Supplementary Estimates and Statements of Excess.

CIVIL ESTIMATES AND ESTIMATES FOR REVENUE DEPARTMENTS, SUPPLEMENTARY ESTIMATES, 1958–59

That a Supplementary sum, not exceeding £5;3,090,145, he granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1959, for expenditure in respect of the following Supplementary Estimates, viz.:—


CIVIL ESTIMATES


Class I



£


1. House of Lords.7,444



4. Treasury and Subordinate Departments
25.000


5. Privy Council Office
248


6. Charity Commission
556


8. Crown Estate Office
5,250


9. Exchequer and Audit Department
10


10. Friendly' Societies Registry
10


13. Government Hospitality
6,000


15. National Debt Office
10


17. Public Record Office
10


22c. Civil Service Remuneration
6,190,450


23. Scottish Home Department
10

Class II



£


1. Foreign Service
595,920


2. Foreign Office Grants and Services
6,651,876


5. Commonwealth Services
487,408


8. Colonial Services
12,804,334


11. Imperial War Graves Commission
75,000

Class III


1. Home Office
2,470,410


2. Home Office (Civil Defence Services)
10


3. Police, England and Wales
690,648


4. Prisons, England and Wales
738,400


5. Child Care, England and Wales
270,000


6. Fire Services, England and Wales
354.680


7 Carlisle State Management District
10


8. Supreme Court of Judicature, etc.
10


9. County Courts
10


11. Land Registry
10


16. Police, Scotland
169,000


17. Prisons, Scotland
158,000


19, Fire Services, Scotland
40,000


21. Law Charges and Courts of Law, Scotland
10


22. Department of the Registers of Scotland
10


23. Supreme Court of Judicature, etc., Northern Ireland
1,071

Class IV


1. Ministry of Education
1,900,000


2. British Museum
67,800


6. National Gallery
125,000


7. Tate Gallery
955


12. Universities and Colleges, etc., Great Britain
1,000,000


13. Broadcasting
10


14. Public Education. Scotland
333,250


17. National Library, Scotland
10

Class V


2. Housing. England and Wales
1,574,000


8. Central Land Board
9,740


9. War Damage Commission
23,000

Class VI


1. Board of Trade
85,200


5. Financial Assistance in Development and other Areas
2,128,990


6. Export Credits
10


9. Ministry of Labour and National Service
10

Class VII


2. Houses of Parliament Buildings
10


3. Public Buildings, etc., United Kingdom
1,110,000


11. Peterhead Harbour
10

Class VIII


12. Fisheries (Scotland) and Herring Industry
10

Class IX



£


1. Ministry of Transport and Civil Aviation
131,700


3. Transport (Shipping and Special Services)
10


4. Civil Aviation
10


6. Ministry of Power (Special Services)
6,002,600

Class X


1. Superannuation and Retired Allowances
1,400,000

CIVIL (EXCESSES), 1957–58


That a sum, not exceeding £94,262 18s. 1d., be granted to Her Majesty, to make good excesses on certain grants for Civil Services for the year ended on the 31st day of March, 1958.


Class and Vote
Excess of Expenditure over Estimate
Appropriations in Aid
Excess Votes



£
s.
d.
£
s.
d.
£
s.
d.


Class II











1. Foreign Service
147,522
19
3
147,512
19
3
10
0
0


Class X











4. National Insurance and Family Allowances
94,853
15
6
600
17
5
94,252
18
1



Total, Civil (Excesses)
£94,262
18
1

Question put and agreed to.

Resolutions to be reported.

Report to he received Tomorrow; Committee to sit again Tomorrow.

WAYS AND MEANS

Considered in Committee.

[Sir CHARLES MACANDREW in the Chair]

Resolved,
That towards making good the Supply granted to Her Majesty for the service of the year ended on the 31st day of March, 1958. the sum of £94,262 18s. 1d. be granted out of the Consolidated Fund of the United Kingdom.—[Mr. Simon.]

Resolved,
That towards making good the Supply granted to Her Majesty for the service of the year ending on the 31st day of March, 1959. the sum of £161,954,391 be granted out of the Consolidated Fund of the United Kingdom—[Mr. Simon.]

Resolved,
That towards making good the Supply granted to Her Majesty for the service of the year ending on the 31st day of March, 1960, the sum of £2,088,445,100 be granted out of the Consolidated Fund of the United Kingdom.—[Mr. Simon.]

Resolutions to be reported.

Report to be received Tomorrow Committee to sit again Tomorrow.

£


2. Ministry of Pensions and National Insurance
83,205


3. War Pensions, etc.
579,400


5. National Assistance Board
4,574,000


Revenue Departments


1. Customs and Excise
326,400


3. Post Office
4,893,000



£58,090,145

Question put and agreed to.

SMALL FARMERS' SCHEMES

9.33 p.m.

The Minister of Agriculture, Fisheries and Food (Mr. John Hare): I beg to move,
that the Small Farmer (England and Wales and Northern Ireland) Scheme, 1959, a draft of which was laid before this House on 24th February, be approved.
I suggest, Mr. Deputy-Speaker, that it might be for the convenience of the House if, at the same time, we debated the Small Farmer (England and Wales and Northern Ireland) Supplementary Scheme, 1959, and I understand that it would also be convenient to both sides if, at this stage, we also debated the Small Farmers (Scotland) Scheme, 1959. Drafts of the last-named Schemes were similarly laid on 24th February.
If that is suitable, I should say that the Schemes for which I am directly responsible, and which I am asking the House to approve, are the first to be made under the Agriculture (Small Farmers) Act, 1959. With a few minor changes, which I shall explain in a moment, they embody the proposals set out in the White Paper published last October.
I do not propose to go into details of the provisions of the Schemes. They carry into effect the proposals contained in the White Paper, and we have had very considerable discussions on those. I would only remind hon. Members that the object of the Schemes is to make small farm businesses more profitable by giving the farmer, first, advice on a programme for improving his business, and, second, some extra cash to help to carry that advice into practice. That is the basic idea behind the Scheme. The House will recall that "small farmer" is defined by reference to the acreage and standard labour requirements of his farm business.
The Supplementary Scheme is intended, first, to give interim help to those who are in the queue for the Small Farmer Scheme, those who cannot be dealt with straight away. Secondly, of course, the Supplementary Scheme will provide temporary help to some of those who have been receiving assistance under the old marginal production scheme but who will not be eligible for the Small Farmer Scheme.
I want to draw attention to the changes which have been made in the Schemes since the publication of the White Paper. There is one change which has been decided on since our discussions on the Bill. It has been implicit in all our discussions about the Small Farmer Scheme that it should provide once-for-all help. We have now spelt out this principle in paragraph 8 of the draft Scheme. It will be seen that, by sub-paragraph (1) it is provided that a person carrying on two or more eligible farm businesses may have a grant-aided improvement programme for only one of them.
During the discussions on the Bill, a number of hon. Gentlemen made the point that it might be possible for a farmer to have several small farms which, if run as separate businesses, would all be eligible. If my memory is right, the hon. Member most interested in that was the hon. Member for South Ayrshire (Mr Emrys Hughes). We have thought about it, and, in order to make the position crystal clear, we have decided to meet the point by the definite limitation in subparagraph (1) to which I have just referred.
Sub-paragraph (2) of paragraph 8 provides that, once a small farmer has completed an improvement programme, he cannot be given further help under the Scheme either for the same or for a different farm business. By subparagraph (3) we provide that a small farmer who moves from one farm to another before actually completing his improvement programme may have a programme approved for a second farm, if it is eligible, but—this is important—financial assistance for the second programme will be reduced by the amount of the grants he has already had under the first programme before he moved.
The second change, which has already been announced, relates to the farm business grant. Paragraph 10 of the White Paper said that this would be paid in four equal instalments spread over three years. To meet some of the very strong arguments put forward by hon. Members opposite I did, on Third Reading, as the House will recollect, say that the four instalments would now be paid at intervals of 6, 12, 18 and 30 months from the beginning of the programme. That announcement is covered by paragraph 5 (1) of the draft Scheme.
The third change relates to the list of standard labour requirements. A provisional list was given in Appendix I of the White Paper. We invited and received comments on this provisional list from the farmers' unions and from other sources. Some hon. Members made useful suggestions. As a result, I decided to make a number of minor changes in the list. I set out those changes in reply to a Question by the hon. Member far Sunderland, North (Mr. Willey) on 26th January. They have now been incorporated in the table of standard labour requirements set out in the Second Schedule to the draft Scheme.
I now turn to the Supplementary Scheme. There are only two differences here from the proposals in the White Paper. First, the table of standard labour requirements in the Second Schedule is the same as the one in the Small Farmer Scheme. Secondly, we have introduced a limit of £70 to the supplementary grant for ditching. This supplementary grant, as the House knows, is at the rate of 35 per cent. of the cost and is in addition to the ordinary ditching grant of 50 per cent. of the cost.
The limit, therefore, would operate in only a few cases—that is, where the gross cost of any ditching work done during the period of the scheme exceeds £200. I hope that hon. Members have been able to follow my mathematics. In these cases, the farmer would still be eligible for the ordinary 50 per cent. grant on the cost of all the work—that is, if the total amount exceeds £200.
As hon. Members know, we have been receiving provisional applications under the schemes since 15th January. I am glad to be able to tell the House that the initial response to the scheme has been first class. Up to last night. less than eight weeks from the start, we had received 11,159 applications under the two schemes, and about 90 per cent. of these are prima facie eligible. Under the Small Farmer Scheme, we therefore have already well over half the number of applications which we hoped to be able to deal with in the first full year of the Scheme.
I submit that the figures which I have given to the House fully vindicate the estimates which my hon. Friend the Joint Parliamentary Secretary and I gave during the passage of the Bill. They show that small farmers think that the help which we are offering is worth having. They also show that we were right, despite the strong arguments put forward by the Opposition, to resist attempts to widen the scope of the Scheme at this stage. Had we done so, we might well have taken on far more than we could possibly have dealt with effectively and, therefore, would have endangered the success of the entire Scheme.
I am sure that the House will join with me when I say that the progress so far made reflects great credit on those of my staff who have to deal with the Schemes, both in the National Agricultural Advisory Service and in my Ministry's divisional offices. They are coping very well with the very considerable extra burden which the Schemes have placed upon them.
As the hon. Member for Sunderland, North realises, we have not yet been able to give approval to any farm business plans, but we expect to be able to begin to do so within a few days of the coming into operation of the Schemes. From the beginning of next month a large and

growing number of small farmers will be engaged on improvement programmes drawn up with the advice of the National Agricultural Advisory Service. I am sure that they will result in a substantial and lasting improvement in efficiency and profitability.
I commend the Schemes to the House with real confidence.

9.44 p.m.

Mr. Frederick Willey: We welcome the minor changes which the Minister has made in these Schemes, and I personally welcome the fact that he has obviously recovered to vigorous health. Anyone who heard his self-eulogy would imagine that this Scheme had been warmly received by the farming community, but we all know that it has had a very poor reception. The Minister drew attention to the 11,000 applications which have been received. With farming in its present depressed state, no one can be surprised that there is a good deal of alacrity to seek aid. We all know, and the farming community knows, that this is little more than a temporary dole for some farmers at the expense of the rest of the agricultural community.
I would say in passing that I hope hon. Members opposite will now forever hold their peace about farming from Whitehall. They need only look at the Second Schedule to the first Scheme. They need only remember that the Joint Parliamentary Secretary told us that the programme will lay down in detail what the farmer will do. They need only remember what he said about routine inspections and all the rest. As I have said before, this is a bureaucratic Scheme. We all know that it was devised by the bureaucrats.
What I would have expected to hear from the Minister tonight was something about those administering the Schemes. Why has he not said anything about the National Agricultural Advisory Service? What steps is he taking to improve and strengthen this Service? After all, the Caine Committee recommended a strengthening of the Service by 25 per cent. without regard to these Schemes. The National Farmers' Union has complained that, as a result of these Schemes, the Advisory Service will be siphoned off in parts of the country where the services of the N.A.A.S. officers have been invaluable. I should have thought that if the


Minister was as enthusiatic as he appears about these Schemes and the effects that they may have, he would have told us what steps he was taking to encourage recruitment to the National Agricultural Advisory Service.
This is a limited Scheme and it provides little more than a temporary dole for some sorely-pressed farmers. What the Minister has not done is to call our attention to the fact that he is bringing to an end the marginal production schemes. They are being discontinued and in their place we are getting a Supplementary Scheme which is a terminal scheme. What the right hon Gentleman has not reminded us is that he is taking these steps because there has been a change of policy, which has been frequently admitted, by the Government towards agriculture. They are no longer seeking maximum production but are seeking what they term economic production.
The whole time, the Government are lowering their sights about agricultural production. One has only to read the White Paper to see this. It is because we realise that this is a definite terminal scheme that we are so sorely disappointed that there is no provision for loans in the Scheme. We not only share with the National Farmers' Union its belief that it was misled at last year's Price Review and its view that combined grants and loans would have provided a more flexible and economic scheme. We not only share M r. John Cherrington's view that the small farmer will probably lack the capacity to manage the flush of grass and provide the stock to eat it. We not only remember my right hon. Friend the Member for Don Valley (Mr. T. Williams) portraying the dilemma of the small farmer who will have to decide whether to buy the front or the back half of a heifer, because certainly, in many cases, the Scheme will not enable him to buy the whole. We also realise that despite the advice he was given, the Minister refuses to countenance loans and so emphasised again and again that this was a Scheme which was limited and terminal. As the National Farmers' Union says, the Government's proposals do not measure up to the basic need for capital. Everyone knows that what the small farmer

needs above everything else are better credit facilities—and that again has been emphasised by the Caine Committee Report—and provision for and encouragement of co-operation. We have not had a word about credit or about the encouragement of co-operation in these Schemes which we are now discussing. The party which is dominated by bankers and middlemen naturally finds it very difficult to do anything for the agricultural community so far as credit and co-operation are concerned. [Interruption.] I would remind the hon. Member for Leominster (Sir A. Baldwin) that when the Minister was questioned about this, he said:
The sort of chap whom we are trying to help is not the sort of chap who likes to have loans, and I shall he very sorry for any successor of mine who tried to get the money back.

Sir Archer Baldwin: May I point out to the hon. Gentleman that the farmers do not want more loans, but the ability to pay back the loans already made?

Mr. Willey: The Minister said that, as a result of this Scheme, he does not expect the farmer to be in any better position to repay any loan.

Mr. John Hare: The hon. Gentleman is really trying to misquote me. He is making a very amusing speech, but he knows very well that he is trying to give an entirely wrong impression. What I have said is that the small farmers at this juncture, before they have had the chance to improve the credit-worthiness of their farms, do not wish to take on extra commitments, and that is why these grants will be of real assistance. After they have increased their credit-worthiness, they can take on loans.

Mr. Wiley: I ought to say that I am much obliged for the right hon. Gentleman's intervention, but I am not, because I quoted the exact words he used. The essential basic point which I am making at the moment is that the provision of aid by way of loan would have demonstrated a continuing interest in the welfare of the small farmer, and that is what the right hon. Gentleman has avoided.
I would say in passing that we have not had any satisfaction on the question


whether in fact the small farmer is likely to enjoy the benefits of the Scheme at all, because the right hon. Gentleman was pressed on the question of rents and was asked whether the money would be lost to the small farmer in the form of higher rent. We have had no reply and no assurance from the right hon. Gentleman on that.
These Schemes are not only inadequate in the assistance which they provide, but they are inadequate in the number of farmers whom they help. We have to remember that there are half a million agricultural holdings in the United Kingdom, and that these Schemes, if the Minister holds to his estimate, will help 25,000 this year—15,000 in England and Wales. We must recognise that the fact that the farmers have to satisfy two tests—the acreage test and the standard man-days test—rules out all farmers with less than 20 acres. Thus, it rules out over 160,000 holdings in England and Wales alone. It rules out all the small farmers who have resorted to intensive cultivation. It rules out all the small farmers on poor land.
What does the N.F.U. say about this? The National Farmers' Union has made it clear that, "as the Schemes are now drawn, the number of holdings which will qualify is not nearly sufficient. In its Resolution, the N.F.U. Council said that it maintains "that very many potentially viable small farmers will be unaided." What did Sir James Turner, as I suppose he still is, say?
The scheme excludes a lot of good people who are definitely viable. These are the chaps on the way up. To refuse them assistance is to take the stepping stone out of farming.
What did several of the Government back-benchers say? I would remind the hon. Member for Leominster of what he and his colleagues said. They said that the Government should select one or other of these tests. His colleagues said that the limits should be extended, but the right hon. Gentleman has not only ridden roughshod over the N.F.U., but has disregarded them as well.

Sir A. Baldwin: I think the Minister has already explained that the reason for the limit was that he did not want to swamp the N.A.A.S. and when he gets the Schemes through, he will no doubt bring in another Bill to help the farmers who are excluded at the present time.

Mr. Willey: The right hon. Gentleman has not said anything about extending the N.A.A.S., but I should have thought that that was what he would have done if he had agreed with the hon. Gentleman. The hon. Gentleman knows full well that he is now driven to support his Government but that he pleaded very eloquently for the election by the Government of one or other of these tests. The Government have not done that. I remind him also that the Government have completely disregarded the position of the part-time farmer, though no one knows better than he that there are many parts of our countryside which can be efficiently and economically farmed only by part-time farmers.
Not only are many farmers excluded, but many of the small farmers excluded are, as a result of these Schemes, worse off because they are obliged to contribute towards paying the cost of the Schemes although they themselves do not benefit. In fact, many of the smaller farmers, particularly many of the marginal farmers, are quite callously being written off by the Government. They are being driven to the wall as a matter of Government policy. It is cold comfort for them to read in the White Paper on Assistance For Small Farmers that the Government have been studying their problem and will continue to do so. We know that that is a convenient formula to tide over the General Election.
The Minister—and this was an odd step for a Minister of Agriculture to take—called in aid the Economist, but the Economist has emphasised that the Government must face up to this social responsibility. There is a social side to the problem and a national responsibility, but all that the Government can say is, "We are considering this problem". I would remind the Minister that the Economist has now deserted him. He has no supporter left. The Economist said recently:
The present Small Farmer Scheme should be converted into a much larger scheme for the improvement or rehabilitation of sub-economic units.
I want to turn to the Price Review because, after all, the cost of the Schemes is borne on the Price Review. I complain of the Schemes being brought forward before we know the Price Review award. This year, as the White Paper points out, the net additional expenditure


of about £6 million will be taken into account in the 1959 Price Review. This is a redeployment of moneys provided by the rest of the industry, but, possibly for that reason, the sum which is thus gained is hopelessly inadequate.
I would remind the Minister once again that there have been several studies not only of the small farmer but also of the hill marginal land farmer and that all these studies have shown, surprisingly enough, that the small farmer and especially the hill farmer is receiving a far smaller proportion of the assistance to agriculture than the volume of his output would justify. This Scheme does nothing to remedy that.
I remind the right hon. Gentleman that his Parliamentary Secretary rather made a virtue of this and repeatedly pointed out that here we are providing £6 million out of a total balance of guarantees of £1,268 million last year. Obviously, a measure on this scale will not redress the balance against either the small farmer or the marginal hill farmer.
Again, we know that over the past few years the position of the small farmer has relatively deteriorated. In fact the most recent N.F.U. farm accounts show that his, position has not only relatively but absolutely deteriorated over the last year for which the N.F.U. have accounts, and undoubtedly it has done so over the past year. In other words, under present Government policy not only are we worse off the more we produce—because the production figures show an increase over those years—but the smaller we are the harder we are hit, the more vulnerable we are to Government policy. We have only to think for a moment to realise this. There is not the slightest doubt that the result of the Government's policy of throwing the farmer on the mercy of the middleman bears more hardly on the small farmer than on anyone else. He has come out of this worse than has the larger farmer.
We also have to admit the fact that over the past few years, again because of Government policy, there has been a consistent under-recruitment policy, and this action also has borne more hardly on the small farmer. We have only to think of commodities—milk, pigs and eggs—to realise this. Think of the present pig position. What help can these

Schemes give in the present situation? There are also rumours about eggs in the present Price Review. The fact is that the greatest burden undoubtedly has been borne by the small farmer, and this small redistribution will not improve his position to any substantial degree. I warn the farming community that already within two years of the 1957 Act we have a breach of the principle established by that Act because, as regards the general prices, the cost of this £6 million Scheme is borne on those prices over and above any provision made by the 1957 Act.
I concede that the present Price Review is a pre-election one and we must look ahead over the next three or five years of this Scheme. Again I remind the right hon. Gentleman that the Economist said that if the Schemes are to benefit the national economy, there will have to be further downward revisions at the next and subsequent Price Reviews. I have pointed out the exceptional position of this year's Price Review, but we all know that the purpose of the 1957 Act was to provide a downward escalator for farmers. In this context the Schemes are not sufficient to alter the disastrous position of the small farmers today. I would remind the right hon. Gentleman that the only difference between himself and the Economist is that the latter recognises the results of Government policy.
The Economist is more politically alive than the right hon. Gentleman, and that is not surprising because, as I said, he is the prisoner of a very bureaucratic Scheme. The Economist pointed out that it is the admitted purpose of the Government, as the result of the 1957 Act, progressively to squeeze the price guarantees and to push thousands of farmers out of farming. It recognised that this poses for the Government a serious social problem. The Economist gave the Government this warning; it said:
An unadulterated price squeeze may precipitate not merely a social problem but also an economic and strategic hazard, for a widespread deterioration of the land's capital and equipment is one thing which ought not to be allowed.
That is why the Economist is now saying to the right hon. Gentleman that the present Schemes are completely inadequate. The Government must do something more than they are doing to pursue the policy which that paper and the


right hon. Gentleman apparently jointly support. Therefore, as I say, the right hon. Gentleman is now left without a supporter anywhere.
The Economist at any rate realises that if the Government are to pursue their present agricultural policy, any such Schemes as the present ones are not only hopelessly inadequate but dangerous. I beg the right hon. Gentleman not to be complacent about this but to recognise that this is little more than an alleviation attempted to distract the farmer from the deterioration in the outlook for agriculture which the Government have brought about over recent years—the right hon. Gentleman seems to be getting upset about this.

Mr. John Hare: I am not getting upset.

Mr. Willey: It happens to be a fact. I would point out that the Economist and the National Farmers Union agree that unless he takes further steps he is bringing some sections of the agricultural industry to disaster and he should pay attention to it.
What do the N.F.U. say about the Schemes? They regret them. It is true that they are statesmanlike enough to say that they will endeavour to work them, but they regret the fact that the Government have failed in any way to modify the Schemes.

Sir A. Baldwin: Still production goes up.

Mr. Willey: And the more production goes up the worse off is the farmer. Among the farmers at large, the worst off is the small farmer. I would advise farmers not to boycott these Schemes but to take the greatest advantage of them. I would, however, ask them to recognise that the present consequences of the Government's policy on agriculture are leading this industry, so far as many of those who work the hardest in the industry are concerned, into a blind alley.
I hope—we all hope—that the greatest advantage will be taken of the Schemes. I also hope that when the General Election comes the farmers will rid themselves of the present Government and their policy before they are led to real disaster and before it is too late.

10.7 p.m.

Mr. Tudor Watkins: I have stayed a long time this evening to speak on behalf of the Welsh farming industry. I am glad to find from the Minister's statement tonight that some minor changes have been made in the Scheme itself. This will certainly be welcome.
I would have liked the Minister to have said when he will reconsider the position of those farmers with under 20 acres, because I am sure that he is aware that there are quite a number of these small farmers with between 20 and 100 acres who, because of their efficiency, have worked themselves out of getting any further assistance. I am sure that the Minister has an answer to that.
I should like to know what is the position of those with under 20 acres, because the right hon. Gentleman has given information to us in Committee that he is considering what is to be done in the future. I am very glad to find that the Chairman of the Advisory Committee for Wales and the N.A.A.S. said that one-third of the national output of British agriculture conies from farms of 20 to 100 acres. This is very important.
The Minister gave us figures recently showing that in Wales 36 per cent. of our eggs came from this type of farm, 32 per cent. of fatstock, 40 per cent. of milk and 18 per cent. of crops. That is a very substantial contribution. I suggest that a substantial contribution is given by those with farms of under 20 acres. At the same time, I realise that this Scheme is bound to make a valuable contribution to the farmers I represent in my constituency, particularly those in the mid-Wales area. I hope that the right hon. Gentleman's officers will look leniently at cases on the borderline which should come into the Scheme.
When the Minister's advisory officers make speeches—I do not criticise what they have said so far—I hope that it will be understood by everyone that this Scheme is not designed to help those who are not pulling their weight, but people who are doing their best for agriculture. It is not meant to help those people who regard farming as a side-line. A number of such people are under the impression that they should be helped more than anyone else. Were that to be the case, it would give no satisfaction to the working


farmer whose profits often do not amount to as much as the wages of agricultural workers.
I hope that advice will be given to a number of my constituents and to people in other parts of central Wales who wish to change over from milk production to livestock rearing. A number of farmers produce milk because they need the monthly milk cheque, and the only way to encourage them in the future is to provide a guaranteed market by means of assistance of this kind so that they may create a viable economic unit. I hope that businesses will be assisted so that they may contribute more than at present to agricultural production.
Marginal production plays an important part in farming and I hope that something will be said about that either by the Minister or by the Under-Secretary of State for Scotland. I regret that each time I speak, a reply is made by the Joint Under-Secretary of State for Scotland. I hope that the Minister will take note that if the Select Committee on Procedure gets its way there will be discussions on agriculture Estimates in the Welsh Grand Committee. If that happens, we shall not tolerate the presence there of a Joint Under-Secretary of State for Scotland.
I hope that the Minister will give an undertaking that this Scheme will not affect the working of the marginal production scheme and that farmers who have reached a certain standard with the assistance of that scheme may be permitted to seek assistance under the Small Farmer Scheme if they wish, provided that they do not also claim under the other scheme.
The Minister told us the number of applications which have already been re-

ceived, but he did not say whether they were for England and Wales. I assume that they relate to England and Wales, but when we are given these figures we are not told the proportion which relates to Wales. The two figures are lumped together. I have read Press reports referring to a large number of claims coming from Wales and I should like to know the figure. It would be beneficial for farming circles to be informed about the number of people who are eligible and who have made application under this Scheme.
In the circular which was sent out to the county committees it is stated that appeals may he made against the decisions of officers and I hope that that fact will be made known to everyone, because it is important. In borderline cases, and there may be many of them where it is a question of part-time farming, it is the holding itself which will count and not the number of people working there. Consequently, there will be cases where appeals may be made to the county committees.
I do not share the pessimistic view of my hon. Friend the Member for Sunderland, South (Mr. Willey). He probably has not the same experience as I have had of central Wales. I do not mean of farming, because I am not a farmer, but I am concerned about the urgency of the problem in central Wales and I am seeking anything which will assist the farmers in that area. This Scheme makes a contribution towards it. I hope that in the near future the Minister will say, "In view of the appeals made by the hon. Member for Brecon and Radnor, I will come forward with another scheme which will support farmers with under 20 acres".

10.16 p.m.

Mr. William Ross: I apologise for inflicting myself upon the House as an expert on agriculture. My presence here is due to the fact that my hon. Friend the Member for Hamilton (Mr. T. Fraser) had to leave urgently for Scotland.
I am not without some knowledge of agriculture, Mr. Speaker, because, as you know, the Kilmarnock constituency is probably one of the best agricultural constituencies in Scotland. One could not have been a Member for an agricultural area in Scotland during the passage of the recent Small Farmers' Act without having had brought to one's attention the feeling of Scottish farmers about that Measure. Whatever may have been said about the reaction of the English farmers, the Scheme and the Act from which it came were received by the Scottish farmers with unanimous resentment and opposition—

The Joint Under-Secretary of State for Scotland (Lord John Hope): The Joint Under-Secretary of State for Scotland (Lord John Hope) indicated dissent.

Mr. Ross: I do not think that the Joint Under-Secretary of State will deny that it was described as a "body blow" to Scottish agriculture. I am surprised that he should disagree with me. There is a date which I am sure will stick in the hon. Gentleman's mind. It is 21st February, 1959, when there appeared in that usually rather friendly-towards-the-Government newspaper, the Scotsman—Scotland's national newspaper and not an irresponsible one—on the front page, a heading which was as follows:
Shaky record of Scottish Office.
Prestige of Department in decline.
The article started with the Secretary of State, passed to the Minister of State, and eventually came to the Joint Under-Secretary of State. This is what it had to say:
Lord John Hope, in the Pentlands Division of Edinburgh, is comfortable enough with a majority of 7,485. I wonder how he would fare if his future depended on the votes of the farming community.
That arose directly out of this Scheme. I am sure that the attention of the hon. Gentleman was directed to the remarks on page 15, and it may be that his eyes

strayed to page 14—perhaps he had not recovered and did not get to that page—upon which were remarks credited to Mr. J. N. Sime, of Laurencekirk, retiring president of the Aberdeen and Kincardine branch of the National Farmers' Union.
I am sorry that there is not a supporting Conservative—again I am sorry, because we do not call Government supporters "Conservatives" in Scotland, but "Unionists"—in the House to give us his opinion on this matter, but here is the opinion of Mr. Sime. Speaking of the "disastrous effects of ending M.A.P." and of replacing it by the Scheme that we have before us, he said that the Government had been forced to continue M.A.P. for a year in Scotland, and we might look upon this as a breathing space. He went on:
This breathing space must be taken full advantage of to get the Government to go on with an adequate and properly selective scheme or its equivalent. If the M.A.P. scheme were suddenly to come to an end, there would be a spate of cattle and then unemployment down our glens. It would spread to the towns and might even sweep away this marginal Government.
People in that part of Britain are not irresponsible and do not make irresponsible statements. They are judging the Government on the merits of the proposals the Government are making and the effect they will have on Scottish farming. We have been given the figures of M.A.P. and it will be obvious that Scotland did very well. Out of about £3 million a year for the whole country, including Northern Ireland, the small farmers of Scotland, and not necessarily only the small ones, got £1,200,000 every year out of it.
These grants were related to the poverty of the land, to the need of these farms to get assistance to make them proper economic units. Now we have completely departed from that and it will mean, when in full operation, that at least 3,000 of the farmers in Scotland who are now receiving help will cease to get it. Can we wonder that there has been no welcome for this in Scotland?
When we further realise that in this operation those 3,000 will have additional financial responsibilities placed on them to succour those who are to get any advantage out of the Scheme in Scotland, it is


no wonder that we see it stated in the first lines of the Scheme that it is brought in
with the approval of the Treasury.
About the only people who do approve of it are the Treasury because, instead of the Treasury supporting small farmers, 3,000, by a reduction of subsidies effected by the global figure, will support farmers in the Scheme.
By the very nature of the new Scheme, farmers who, hitherto, because of the poverty of the land they are farming, were assisted will have to pay to provide further assistance to people who at present, before the Scheme is introduced, may well have economic units. It is unfair, and I can well understand the reactions of Scottish farmers.
I am surprised that we have had no observations from any representatives in the House of the farming community of Scotland. Here, if ever, we are having applied a centralised conception of farming and farm efficiency. Anyone who knows Scotland knows that the one thing we cannot apply is a centralised conception of farming or measurement of efficiency to farming in Scotland. It is entirely different in the Orkneys from Berwickshire. The change of climate from North to South makes nonsense of these Schedules, if they were not already nonsense.
In St. Andrew's House, or at the Ministry of Agriculture, there must be someone whose sole task, during the past year, has been, and will be in the coming year, to think of new titles for new Measures which are to be introduced. The farming community has to get used to finding new terms such as "standard labour", "standard man-days", "farm business plans", "farm business grants" and "field husbandry grants". I suppose that in time we shall get the usual set of contractions such as, S.L., S.M.D., F.B.P., F.B.G., and F.H.G. If I know the farmers of Scotland, they will apply another term to the whole lot. [Laughter.] I am very glad that hon. Members have been following me.
We have had this question of a centralised conception so often. There used to be a tag, "The man in Whitehall knows best", but, when one looks at the supplementary conditions on page 2 of the Scottish Scheme one finds that the Secretary of State has to approve an application in writing, that there is

to be no specific modification except with the consent of the Secretary of State, and that persons have to be authorised by the Secretary of State to give the information required by the Secretary of State. We shall soon be back to a position in which we find the Secretary of State in this era of freedom as the great centraliser and consenter, everything having to pass his eagle eye.
This is nonsense. There should be some delegation of the Secretary of State's authority in these matters, because the proposed system will cause a lot of trouble. We hear plenty about form filling, but when the farmer starts to work out the man-hours and reads the calculations in the Second Schedule of how it is to be done, he will be startled. It is worth reading.
The Second Schedule says:
The standard labour requirements of a business on any date shall be expressed in standard man-days calculated, except as is otherwise provided in the succeeding paragraphs, by multiplying respectively the number of standard man-days set out in the Table below in relation to any kind of crop or livestock therein mentioned by the total number of acres of that kind of crop or the average of the numbers of that kind of livestock shown to the satisfaction of the Secretary of State.
—he could not keep out of it he had to come into it here—
to be comprised in the business during the 12 months immediately preceding the date to which the calculation relates, adding together the results so obtained and increasing the total by 15 per cent.
Why 15 per cent.? Who thought that out? I hope that the Joint Under-Secretary of State will tell us why it should be 15 per cent.
Paragraph 6 of the Second Schedule begins:
If the Secretary of State is satisfied that by reason of special circumstances the acreage of crops, or of any kind of crop, or the number of livestock, or of any kind of livestock comprised in the business …
How is that to be worked out? What is the nature of the "special circumstances"?
Paragraph 7 gives one of the alternative considerations before the plan is started. The plan is related to standard man-days between 250 and 450 or not less than 275 by the time the plan is completed. The Second Schedule gives a wonderful calculation of how this is to be done. I want an explanation of what


the Schedule means, because I do not follow it.
I want, next, to take up a point arising from what was said by the Minister. It applies to Scotland, too. It reads:
Where a person carries on at the same time two or more small farm businesses to which this Scheme applies, no grant shall be made under this Scheme in respect of more than one of those businesses.
Is that entirely fair? A man may well have two small businesses the acreage of which, added together, is less than the maximum acreage of the scheme, which is 100 acres. He might have two small farm businesses each of 40 acres. Why should they not be treated as separate businesses? Why should a plan be sanctioned in respect of only one of them and why should grants under the plan be made in respect of only one of them? I do not follow that point of view. If it were a father and son there would be no difficulty because the businesses would he treated as two businesses.
I do not think that there has been proper appreciation of this difficulty. It may well be that the Minister and the Secretary of State for Scotland have been concerned to prevent anyone from split-ting his farm into two and thereby qualifying for two grants when, if he had not split the farm, it would have been over the maximum of the Scheme. I hope that the Minister will consider the point, although it is not the only point of difficulty, because many complications will arise out of the Scheme and out of what the Minister has said.
The Minister explained that by paragraph 8 (3) of the actual Scheme for Scotland,
Where any person ceases to carry on a small farm business to which this Scheme applies before the completion of a farm business plan approved …
and the man goes to another small farm, he will be entitled to receive only the maximum for the second farm minus what has already been paid out on the first one. What happens if the maximum on the second farm is below what has already been received in respect of the first one? He gets no help at all. The permanence of his future prosperity will be determined not by the farm he left, but by the farm he has. If we really mean permanently to improve these small farms, let us relate the grants to the farm and not to the man.
It is here that the folly of this proposal is demonstrated. Let us look at it the other way. What about the farm that has been left? A new tenant comes in, and two-thirds of the work has been done and paid for. Can the incoming tenant apply for a grant, present a new plan and carry on? As far as I understand the Act and the Scheme, he can. So the person who is being penalised is the man who originated the plan, but who has left and gone to another farm—and it may have been an involuntary move. He may not have wanted to leave, but may have been turned out for some reason.
I do not think that the Minister has spent enough time considering these points. For the farmers in Scotland, the Scheme, in the first year, is quite irrelevant. That is proved by the fact that in the first year we still continue the Marginal Agricultural Production (Scotland) Scheme. 1959. Anybody operating under that Scheme—and I should think that that applies to all the marginal farmers in Scotland—will not receive anything at all this year.
I would like the figures to be correct. We were given a figure of 25,000 farms, of which 15,000 were said to he in England and Wales. The implication was that 10,000 farmers in Scotland would benefit. I suggest that there will be nothing like that number—

Mr. Hare: The hon. Gentleman realises, of course, that Northern Ireland is also covered?

Mr. Ross: I did not think that so many farmers in Northern Ireland would be covered by the Scheme. Could we be told how many people in Scotland will benefit this year, when we take out of consideration those who are already receiving grants in this year under paragraph 7 (a) and (b)?
I can give this Scheme only a very tepid welcome. I would be letting down the farmers of Scotland were I to do more. So many things are left unanswered. One thing that is obvious to Scottish farmers is that the Government have taken the callous decision of abandoning certain farms. They should continue, in a reduced way, the marginal agricultural grants for about three years. This Scheme ends in February, 1964. After that, what is there for the Scottish


small farmers, not only for those under the 20 acres, but for those under the 100 acres?
It is, indeed, little wonder that the Joint Under-Secretary is unpopular in Scotland. It is little wonder that the Scotsman is concerned about the decline in the prestige of the Scottish Office. Once everything is added up and one subtracts from it the benefits which in future are to he denied to Scottish farmers, benefits which they have enjoyed and under which they have had a measure of security and prosperity, it is little wonder that they are expressing not only their concern but their disgust.
It is my regret that there was only one hon. Member for a Highland constituency who has had this trouble in his area who demonstrated his regret so forcibly as to resign. The others have so demonstrated their regret tonight that there is not a single Conservative or Unionist Member in the House to support the Government or to carry on a rebellion against the Government.

Mr. Hare: There is not one single Labour back bencher present except one representative from Wales, the hon. Member for Brecon and Radnor (Mr. Watkins).

Mr. Ross: The fact is, of course, that this is not our Scheme, This is a great Scheme, according to the opening speech of the Minister. I thought that everyone on the Conservative side would be here to mark the introduction of this great new landmark of Tory freedom and prosperity. In fact, of course, the Scottish Tory Members are running round and looking in HANSARD to try to demonstrate to their farmer constituents that, at some time or another, they have said a word to oppose the Government on this Scheme.
The Scottish farmers are disgusted with the Government. It is probably just as well that the noble Lord is where he is; I advise him to stay there. Let him remain in Edinburgh and not venture forth into the agricultural areas of Scotland.

10.37 p.m.

The Joint Under-Secretary of State for Scotland (Lord John Hope): I am grateful for the advice given to me on various

counts by the hon. Member for Kilmarnock (Mr. Ross), particularly the advice he gave me as he finished, saying that I should stay where I was. I am happy to tell him—it is a coincidence, of course—that the advice he gave me is exactly the line which, quite independently, I had decided to try to follow. So at least we can agree on that.
I do not think that there is very much to the taunts he levelled at the absence of hon. Members in certain quarters of the House. My right hon. Friend, I think, answered that extremely effectively so far as the hon. Gentleman's own party is concerned; but let us have the account clear, and recognise that at no time throughout the debate has there been a single Member of the Liberal Party present either in support of or in opposition to this Measure.

Mr. Ross: Or a National Liberal.

Lord John Hope: The hon. Member for Sunderland, North (Mr. Willey) will not, I hope, be unduly offended if I express friendly disappointment at his speech. I thought that, at the very least, we should have a reluctant eulogy of the Scheme. In fact, we had a very long series of carping criticisms. I think, if I may say so, that it was not the hon. Gentleman at his best. He wants the Scheme to be a success. This is, after all, the first time that any Government have tried to help in this particular direction. I have no doubt that, when the moment arrives, the hon. Gentleman himself will indicate at least his quiescent support by not casting his vote against it in the Lobby.

Mr. Willey: I made it quite clear that I am no more enthusiastic about this Scheme than are the National Farmers' Unions. I advise small farmers who do qualify to take the utmost advantage of the Scheme, but I appeal to the Government to recognise that they have brought the industry to a condition where they really must do far more than this to help the small farmer.

Lord John Hope: Whether the hon. Member has improved his case by that last observation is a matter of opinion. At least, he was entitled to make it.
In welcome contrast to the spirit in which the hon. Member spoke, we had the speech of his hon. Friend the Member


for Brecon and Radnor (Mr. Watkins), who was generous and realistic in his attitude to the Scheme. We are grateful to him. I know that he realises that the Scheme will help in places where help is very much needed.
The hon. Member asked a question about man-day limits and he appealed to my right hon. Friend not to be rigid. My right hon. Friend made it clear throughout all stages of the Bill that that was the last thing he intended to be. The hon. Member will realise that what we must do is to see how we get along and learn from experience. That is my right hon. Friend's intention and I am sure that that is the way to proceed.
The hon. Member then expressed the hope that the Small Farmers' Scheme would not spoil marginal agricultural production. He made it a little embarrassing for me to attempt an answer, because he prefaced his question by saying that he would not tolerate an answer from the Joint Under-Secretary of State for Scotland. Having expressed my gratitude to the hon. Member for his generous approach on broad terms, I do not want to test his tolerance by going into detail on this point. He asked about numbers of applications from Welsh farmers. I understand that the number to date is 3,390.
Now I come to the speech of the hon. Member for Kilmarnock. It was a characteristic exhibition, which is always enjoyable from him, of his knockabout party stuff. Almost all of it has been answered dozens of times, because it has been put out as often. I suggest to the hon. Member, however, that in fixing upon the marginal agricultural production side of things, he got rather off the Scheme, which is a Small Farmers' Scheme. Indeed, as he knows, one of the differences between the Scottish Scheme and the English and Welsh and Northern Ireland Scheme is that the Scottish Scheme does not specify a date on which small farmers are deemed to qualify in terms of paragraph 3 of the Scheme, because in the England and Wales and Northern Ireland Scheme that qualification is linked to eligibility for assistance in terms of the Supplementary Scheme. It does not apply in our case for reasons that the hon. Member knows.
I do not think that the House would wish me, at this hour especially, to in-

dulge in a long debate with the hon. Member on the question of marginal agricultural production in Scotland. The question is not wholly irrelevant to this Small Farmers' Scheme, but it could easily become out of proportion on this occasion. I simply ask the hon. Member to bear in mind that, as he knows, we are thinking very hard about the Scheme and he must wait and see what happens, just as the farming community itself is waiting to see.
Incidentally, I am grateful to the hon. Member for quoting an article in the Scotsman containing, evidently, some observations concerning myself. I shall certainly insert the article in my scrapbook, as well as one or two others which I would like privately to show the hon. Member, which contain some not uncomplimentary remarks made in certain farming journals from time to time. There is nothing to it, of course, either way. After all, what one loses on the swings one gains on the roundabouts. I can put that right.

Mr. Ross: Not at the General Election.

Lord John Hope: There will be a swing all right, and in a direction which the hon. Member will not like.
The hon. Member asked about the Schedule. He postulated certain specific positions. They were perfectly realistic and I should like to look into them. I do not want to answer "off the cuff." He asked about the case of the farmer who has two small farms each of which by itself would be too small to qualify. I think the correct answer is that the farmer can come into the Scheme by amalgamating his two farms and counting them as one business, provided that the combined business comes within the terms of the Scheme.

Mr. Ross: He would probably be cut out in relation not to his acreage, but to the standard man-days.

Lord John Hope: He might be over the maximum and it is true that he would be out in that case.
The hon. Member asked me how many will have begun an improvement plan in Scotland by the end of the year. Our estimate is that it might well be about 1,500. That may prove wrong, but that is the way in which things look likely


to be going. If I have omitted to answer any questions that I could have answered without notice, I must apologise to any hon. Member concerned. I will look through the debate to find whether that has happened. Otherwise, I shall answer specific questions when I have had time to consider them.
I beg the hon. Member for Kilmarnock not to lose heart. If he finds the Schedule difficult to understand, let him remember that so many of these things have to be. The Schedule is long-winded, but it improves greatly with prolonged study and I advise the hon. Member to do that before he addresses us on this subject again.

Mr. Ross: I am not concerned for myself, but for the poor Scottish farmers, who have to understand it.

Lord John Hope: I am obliged. I thought that the hon. Member was referring to his own difficulties. So far, our evidence is that the farming community have understood it perfectly clearly.

Question put and agreed to.

Resolved,
That the Small Farmer (England and Wales and Northern Ireland) Scheme, 1959, a draft of which was laid before this House on 24th February, he approved.

Small Farmer (England and Wales and Northern Ireland) Supplementary Scheme, 1959 [draft laid before the House, 24th February], approved.—[Mr. Hare.]

Small Farmers (Scotland) Scheme, 1959 [draft laid before the House, 24h February], approved.—[Lord John Hope.]

AGRICULTURAL IMPROVEMENT GRANTS [MONEY]

Resolution reported,
That, for the purposes of any Act of the present Session to empower the Minister of Agriculture, Fisheries and Food and the Secretary of State to make provisions by regulations as to the payment of improvement grants under the Hill Farming and Livestock Rearing Acts, 1946 to 1956, and as to the payment of grants and contributions under certain other enactments, it is expedient to authorise the payment out of moneys provided by Parliament of any inc-ease attributable to the provisions of that Act in the sums payable out of moneys so provided in payment of improvement grants under the Hill Farming and Livestock Rearing Acts, 1946 to 1956, and of grants or contributions under any of the following enactments as amended by any subsequent enactment, that is to say—


(a) section sixteen of the Agriculture Act, 1937;
(b) section fifteen of the Agriculture (Miscellaneous War Provisions) Act, 1940;
(c) section three of the Pests Act, 1954.

Resolution agreed to.

RAILWAYS (RUISLIP-NORTHWOOD SERVICES)

Motion made, and Question proposed. That this House do now adjourn.—[Mr. Legh.]

10.49 p.m.

Mr. F. P. Crowder: I am very glad to have the opportunity this evening to raise in this House the question of the disgraceful conditions which are persisting and, despite endless complaint, have persisted for a very long time, on the Metropolitan line. I am supported by my hon. Friend the Member for Aylesbury (Sir S. Summers), my hon. Friend the Member for Hertfordshire. South-West (Mr. G. Longden) and other hon. Members who represent the constituencies which have the misfortune to be served by this particular railway.
It is a sad and disgraceful story which I have to tell the House. Originaly this line, which is electrified and runs to Watford and Rickmansworth in the north-east and Aldgate in the east and serves Amersham Chesham, Missenden, Wendover and the town of Aylesbury, provided a clean, well-run service, with smart railway stations and well ordered flower beds, and the trains kept to time. Its main function was to take Londoners in safety and comfort away to the country every day on business and also at the week-end to those delightful parts of the countryside which are represented in this House by my hon. Friend the Member for Aylesbury and myself. Instead, today we have a thoroughly badly run dirty, irregular service which is an abounding disgrace to the Transport Executive which is in control of it.
Let me say at once that I am indeed grateful for the presence of the Joint Parliamentary Secretary to the Ministry of Transport and Civil Aviation. Time and again I and my hon. Friends have written to him on behalf of our constiuents and we have received the greatest possible co-operation and courtesy from him. But I feel that tonight my hon. Friend must be in the position, or feel that he is in


the position, which I have often found myself to be, as a practising member of the Bar, when someone—rather like the London Transport Executive in this case—has committed a disgraceful offence. The solicitor comes to one and says, "This man has to plead guilty. There is very little to be said; in fact, nothing at all. Will you go into court and say something for him, if you possibly can?" I feel that that is the unfortunate position which my hon. Friend finds himself in tonight, through no fault of his own, as representing Sir John Elliot and his team.
The main grounds of my complaint are as follows. There is on this line a decreasing safety margin; there is continual late running of trains; there is poor lighting and ventilation of coaches; there is an extraordinary lack of cleanliness and there is a thoroughly uncivil attitude on the part of almost every member of the staff.
The people who live in the area served by this line are people with small incomes. They get up early in the morning, travel to London, where they work all day, and return late in the evening. They have at times been described as the backbone of the country. A more long-suffering, loyal, uncomplaining section of the community it would be difficult to find. But, due to the conditions which, through sheer neglect, incompetence and ineptitude on the part of the London Transport Executive, have been allowed to persist on this line, even they have been driven to the point of desperation. Even they have been made to make such remarks as "This is no longer the London Transport Executive, it is the London Cattle Board", because of the way they have been treated.
There have been instances time and again of as many as 28 people being in carriages designed to hold only 12 to 16. There have been instances of carriages in which may be found dirty newspapers as much as a week old littering the floor. They are carriages which literally must be about 20 or 30 years old; at any rate, they are in appearance; carriages whose windows are never even cleaned, so that in the winter, when, as frequently happens, a train comes to a momentary stop outside a station, nobody knows whether the train is in the station or not, and doors have to be opened so that people may see exactly where they are.
I have had an absolute volume of correspondence on these matters. I have travelled on the line myself and, speaking from personal experience of travelling on it recently, the conditions which I experienced I should imagine must have been equivalent to those of the Paris Metro under German occupation during the worst period of the war.
It would ill behove a member of the Bar to speak too strongly or with too extragavant language in any matter which concerns the everyday needs of the ordinary people whom I have described, but having seen these conditions for myself, having had endless discussions with people who have endured them for so long, I really feel it my duty to speak in these terms tonight. I hope that in these few words—and they can be very few be-cause my time is limited—I have been able to give the House some indication of what has been going on for a very long time.
We have a further complaint, and that is the sort of casual, almost—not superior—uninterested attitude of the authorities concerned in this matter when they are approached. I have had the advantage of dealing with a Mr. Ellis. Mr. Ellis holds a very high position indeed in one of the big five banks. He is a person who speaks carefully and with restraint. He has taken up this matter on behalf of his fellow passengers with a painstaking thoroughness and conscientiousness which is to be admired. One cannot help feeling that if only he were on the Transport Executive what very different conditions would exist.
This will give the House an indication of how passengers are treated by the Executive. He wrote the Excutive a very careful letter on 29th January, 1958. He received no answer. He then wrote a letter every week for a month, and in the end he received one printed postcard. The first reply he received to those four or five letters, which were long and in detail—I have read them—and which started on 29th January, was as late as 6th March. That gives an indication of the somewhat casual, dispassionate, superior attitude which is adopted by London Transport Executive towards its passengers on that line.
When I asked him about it he said he had got other people to do the same. He said, "The scheme is this. What they


hope is that if you write once or twice and don't have an answer you will do no more about it." Mr. Ellis is not of that calibre. Nor are his fellow passengers, and they and he have carried on correspondence ever since.
To give an idea of the sort of conditions which exist and exist daily, here are just a few examples. Take the 8.32 which goes from Rickmansworth to Liverpool Street, and is due to arrive as late as 9.21. That train was on time twice during the whole of 1958. This is meant to be a fast train, and it has only 24 miles to cover. If the Executive cannot run the trains on time, if they must be always ten minutes late, why not have the grace and courtesy to reprint the timetable so that the travellers at least know where they are?
I saw to my horror the other day that on some railway—I do not think it was this line—there had been produced a pamphlet which was placed on every seat in every carriage explaining to passengers why the trains were late. Passengers in my constituency, and I believe in other constituencies, are not in the least interested in knowing why London Transport Executive is incapable of keeping its trains to the timetable. After all, the country pays for the services and one does not want to pay public relations officers for explaining, for large salaries, why they are making such a mess of the job. What we want to see are the trains on time in accordance with a timetable. 'Then, if the Executive wishes to spend money on putting leaflets on seats explaining how it has been able to get the trains on time, it may be forgiven that extravagance. But to have the impudence to tell passengers why it has made a mess of the job which it has been given to do is, from a psychological point of view, something which even the most patient people will not endure.
Let me mention one or two other matters. Things have got to such a pass on this line that there is no esprit de corps, or so it would appear, among the lower grade of employee. They are net to be blamed in that respect because clearly they have lost all faith in their superiors. In the short time available to me let me give an instance. Drivers have been approached and, as Mr. Ellis

told me, this is typical of the reply he gets: "What is the use, sir, of putting in a defect report when one knows perfectly well that nothing whatsoever will be done about it?".
One of the complaints that we have on this line is that when couplings break, and when passengers are turned out of a train for no particular reason, nobody is given to understand the reason why. The passengers got together and saw the station master at Liverpool Street, who was most reasonable and co-operative. They said "Cannot we have a loud-hailer to tell us what the position is?" He said "I got a loud-hailer for them; it was only going to cost a mere £30. But no, the top people say we must have a public address system at a cost of £1,000 and they are not prepared to do that yet." The battle went on and Mr. Ellis and his friends won; but it took them a year to get that portable loud-hailer system at a cost of £30 from a local shop to enable the station master to carry out his job.
I will give another instance of the train that took the wrong turning. In July, 1958, there were 700 unfortunate passengers in one of these trains. The Aylesbury train from Liverpool Street, instead of going up the track, after Harrow, through incompetence of signal arrangements, ended up at Rayners Lane on the Uxbridge line. Everybody was turned out. Nobody was told why that had occurred or what they were to do, and they all had to make their own way to Harrow.
Then there is the discomfiture on the line, the shrieking of axle-boxes and so on. Let me give another illustration. One day there was smoke pouring from one of these axle-boxes and the train was stopped at Aylesbury. Out got the guard and the driver. They dashed down the line with two large fire extinguishers. They banged them on the ground, as I believe one has to in order to make them work, but, needless to say, they had been neglected for so long, like the rest of the rolling stock on that line, that neither was able to work and I believe the train caught fire.
What is the answer to this? Eventually, after letter after letter, deputation after deputation, and signature after signature, we finally drove the Executive


into a corner and we got this answer from Sir John Elliot:
In my experience an increasing failure rate is inevitable when rollingstock or machinery reaches the end of its time despite a high and expensive maintenance schedule.
That is Sir John Elliot's letter to my friend on 22nd January, only a month or two ago. That is a complete admission, is it not?
It is hoped to improve matters by 1962.
That is a very long time ahead for my constituents and others who are interested in this broken-down railway. In my respectful submission, that simply will not do.
One of the results of this is that people are giving up going by train. They are taking their cars to London. I always thought that was one of the main reasons for traffic congestion in this great city, but who would want to stand on a filthy, dirty platform or in a waiting room with no fire and broken windows, get into a train and stand the whole way to London, with the risk of being turned out half way there or the train arriving late? That is the daily experience these people have to undergo. The answer is that, as most of the stations are near to London, people are bringing their cars into London and adding to the traffic congestion which is very nearly bringing everything to a standstill. This, I know, is one of the biggest headaches of my right hon. Friend.
I know that certain proposals have been made. I cannot go into them in detail because time forbids. The plans are for four tracks instead of two, to replace old rollingstock with tramcar type giving 58 seats per car instead of 80 as at present, and to introduce electrification between Rickmansworth, Amersham and Chesham. The rest of the line is being taken over by British Railways.
I have no doubt that my hon. Friend would like to imply that that is the answer to the problem, but it is not. The present seating in a coach is an average of 80. The proposed seating in a tramcar type of coach—in other words, by converting to a tube type—is 58, representing a 5 per cent. reduction per car. This new type of train will not compensate for the loss of seating. Automatic sliding doors are to be a new

feature. They are known to be draughty and in a country area in the cold days of winter how unpleasant that would be when the doors open at every station. Everyone will be frozen to death. One also knows that the failure of one door causes the withdrawal of the whole train. Everyone will be turned out and, if present conditions exist, they will not be given a reason why. That will be unpopular. Equally, there would be no proper provision for bulky luggage. I mention that because naturally a lot of people travel to these country districts at weekends.
I live at Knebworth, where we have that type of train. They are all too few. Between ten minutes to 9 in the morning and 9.46 there is not one train, although Knebworth is only 28 miles from London. I wrote about it and was told there was no demand and that is an end of the matter.
Time forbids me to say more, but now Sir John Elliot has left this job, cannot we have someone put in his place with a little energy and drive and an interest m the matter, with some knowledge and experience, who really means to get at these problems and not to fob them off? I do not say a word about Sir John Elliot in these matters, because one knows the difficulties he obviously has had to face. He has been there a very long time. Someone has now to take his place. Let it be the right man. Let it be a man who has the drive and the energy to get at this problem and to deal with it in a practical way. I speak in the House tonight not only on behalf of my constituents but on behalf of many thousands of people in neighbouring constituencies who travel on the same line.

11.11 p.m.

The Joint Parliamentary Secretary to the Ministry of Transport and Civil Aviation (Mr. G. R. H. Nugent): I must congratulate my hon. Friend the Member for Ruislip-Northwood (Mr. F. P. Crowder) on securing the Adjournment tonight to ventilate the complaints of his constituents. Naturally I am sympathetic with them in the discomforts which they have experienced on this line and I am also very concerned that it is difficult at present to give them the standard of service there which, naturally, I wish to see. I feel that, although there are obviously grounds for complaint, some of the strictures which my hon. Friend passed


were exceedingly severe, and I am not sure that they were altogether fair in the context of the total service which London Transport Executive has to give.
My hon. Friend observed that Sir John Elliot has ceased to be the Chairman of London Transport Executive and he hoped for someone better, but as this is a suitable opportunity I should like to put it on record that in my opinion Sir John has done an extremely good job and that we shall find it difficult to replace him with a man of equal calibre. I should like to put on record my warm thanks for the service which he has given.
I am in a difficulty in answering my hon. Friend's comments because I cannot go into detail. These matters, as he rightly observed, are primarily matters of management for the London Transport Executive under the Transport Commission and my right hon. Friend's responsibility is for policy, but the Government's policy is relevant in this matter because
is the modernisation of our railways. We are now three years embarked on that policy. It is a very large undertaking; we are providing £1,500 million for new capital and £400 million to finance the deficit in the meantime.
Already over the whole field some fruits are beginning to show from this huge modernisation scheme in improved passenger services in some parts of the country. When I say that this year alone the allocation for capital expenditure for the Commission is £212 million, it shows what large sums the Government are providing to bring about this much-desired modernisation. London Trans-part's share of it is £9 million for this year, and London Transport, too, is well under way with its modernisation programme.
My hon. Friend referred to features of the Metropolitan Line, and I should be the last person to suggest that it does not need modernisation. I agree that it does. I do not travel on it often but this is a case in which one remembers when one does.
As my hon. Friend rightly says, the intention is to extend the electrification to Amersham and Chesham, to double the lines from Harrow to beyond Moor Park, to relieve the bottleneck on the existing two tracks and to provide new rolling stock and station improvement works with it. The completion of this work is

scheduled to be in 1962. It is a long time to wait, I agree, while they have such conditions, but I am assured that the Executive hopes at any rate by next year to be able to make some interim arrangement with the start of the modernisation, which will then be well under way, particularly with regard to vehicles. I have not time now to give details of that, but I shall be very glad to get them from the London Transport Executive for my hon. Friend, and I hope that they will be some help in the interim in a situation which gives anxiety to us all.
I have made a note of his comments about the dirtiness of the coaches. London Transport has its special cleaning plant, but perhaps it is not always successful, and I will see that what he has said is passed on to the Executive. The Executive will, I am sure, do its best to improve the position.
I should like to say just this. I have always thought that, taking the overall picture, London Transport does provide the finest city system of public transport to be found anywhere in the world and I am concerned when I hear aspects of it which seem open to the strictures which my hon. Friend has made tonight. What is needed is modernisation and we have undertaken this huge task, as hon. Members know; and it includes London Transport. It cannot be done in five minutes, but we shall have broken the back of it in five to ten years. We have already achieved an immense amount in getting the groundwork done, and we shall progressively see the fruits of it.
I hope that my hon. Friend will not lay at our door the whole responsibility for this situation. It is taking time, and it has taken the success of this Government to provide the means for this great modernisation scheme. Right hon. and hon. Members opposite, in the days when they were enjoying their political triumphs, in the days when their concern was nationalisation, might have been thinking about modernisation. It was obviously necessary then; there were so many things which needed to be done, and there are still so many things which need to be done at once. Yet, if this modernisation had been started, say, ten years ago, how different would have been the situation today.

Mr. G. Lindgren: The hon. Gentleman is being rather provocative. May I remind him that there has been nationalisation of London Transport since 1933 and that was provided by a Conservative Government?

Mr. Nugent: Yes, but the hon. Gentleman's right hon. and hon. Friends did not give that attention that was so necessary to modernising our railway systems. They went ahead with their political schemes and had they done something about modernisation, we could hope that we should not be in the position in which we are today.
I will pass on to the Executive what my hon. Friend has said because I know that the Executive is anxious to give a first-class service. It is of concern to us as a Government, as I know it is to the Executive, that there is any ground for criticism such as that which has been made tonight. London Transport is, however, giving a very good service and it will continue to do so. But we must remember that it struggles under some extraordinary conditions; for instance, coaches which are out-of-date and tracks which are sometimes unsuited for the tremendous weight of traffic which passes over them. I hope that my hon. Friend will take back to his hard-pressed constituents the sympathy and an expression

of the concern of the Government and also the assurance that London Transport is doing its best and that we, as the Government, are making every effort in the form of modernisation, which we shall press ahead just as fast as we can.
At the same time there are aspects of modernisation which cannot be achieved as quickly as we, or he, would like and that is especially so when we remember that the services have to go flat out during the day and for most of the night in order to carry the tremendous number of commuters who daily travel to and from the centre of London. I hope that the day is coming when that service, good though it is, will be more comfortable, more speedy, and that the causes for complaint which my hon. Friend has referred to will be a thing of the past. Having ventilated his troubles on behalf of his constituents I hope that they will find that—

The Question having been proposed after Ten o'clock, and the debate having continued half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at nineteen minutes past Eleven o'clock.